CMS Formulary

Displaying 180381-180390 of 1611142 results.
ID: 180381
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180382
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 180383
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180384
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 180385
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180386
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 180387
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 180388
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 180389
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 180390
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30