CMS Formulary

Displaying 183681-183690 of 1611142 results.
ID: 183681
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183682
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183683
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183684
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 183685
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 183686
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 180
ID: 183687
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 180
ID: 183688
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183689
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183690
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0