CMS Formulary

Displaying 184231-184240 of 1611142 results.
ID: 184231
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1606349
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184232
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 242892
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 184233
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1149632
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 184234
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 242891
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 184235
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 248478
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 184236
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 198296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184237
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184238
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 966787
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184239
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 966793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184240
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0