CMS Formulary

Displaying 183701-183710 of 1611142 results.
ID: 183701
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183702
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 183703
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 183704
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1603365
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 183705
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 21
ID: 183706
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 183707
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 183708
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 183709
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 183710
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 672152
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30