CMS Formulary

Displaying 184751-184760 of 1611142 results.
ID: 184751
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 184752
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 184753
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 184754
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 808751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184755
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 808753
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184756
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 808744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184757
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 808748
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 184758
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 184759
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 184760
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0