CMS Formulary

Displaying 184701-184710 of 1611142 results.
ID: 184701
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184702
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184703
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 50
Qty Limit Days: 30
ID: 184704
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197738
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184705
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184706
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184707
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 184708
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 184709
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 184710
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 977939
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30