CMS Formulary

Displaying 185051-185060 of 1611142 results.
ID: 185051
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185052
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185053
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185054
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185055
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185056
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 185057
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 185058
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 185059
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 185060
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30