CMS Formulary

Displaying 181501-181510 of 1611142 results.
ID: 181501
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181502
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 181503
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053753
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 181504
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 1006688
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181505
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 181506
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181507
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181508
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 236
Qty Limit Days: 28
ID: 181509
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 181510
Formulary ID: 00021079
Formulary Version: 13
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0