CMS Formulary

Displaying 184721-184730 of 1611142 results.
ID: 184721
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184722
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184723
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184724
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184725
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184726
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184727
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184728
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184729
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184730
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0