CMS Formulary

Displaying 183611-183620 of 1611142 results.
ID: 183611
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183612
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 183613
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183614
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 810075
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183615
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 810079
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183616
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 21
Qty Limit Days: 28
ID: 183617
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2057205
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183618
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2057216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183619
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2057212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183620
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2057219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0