CMS Formulary

Displaying 184671-184680 of 1611142 results.
ID: 184671
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184672
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184673
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184674
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184675
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 184676
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184677
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1543182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184678
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 184679
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184680
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 996097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0