CMS Formulary

Displaying 183471-183480 of 1611142 results.
ID: 183471
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992816
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183472
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183473
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992695
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 183474
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992703
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 183475
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992691
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 183476
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1992700
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 183477
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183478
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183479
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183480
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0