CMS Formulary

Displaying 184471-184480 of 1611142 results.
ID: 184471
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184472
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184473
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184474
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 991086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184475
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 184476
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 184477
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 184478
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1375948
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184479
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 28
ID: 184480
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1596781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30