CMS Formulary

Displaying 184401-184410 of 1611142 results.
ID: 184401
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310497
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184402
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184403
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184404
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 184405
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 184406
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184407
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184408
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184409
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184410
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0