CMS Formulary

Displaying 183671-183680 of 1611142 results.
ID: 183671
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2166143
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 183672
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2196900
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183673
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 180
ID: 183674
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1541594
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183675
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183676
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183677
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183678
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183679
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183680
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0