CMS Formulary

Displaying 185071-185080 of 1611142 results.
ID: 185071
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 185072
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 185073
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185074
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185075
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185076
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185077
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185078
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185079
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 856987
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 185080
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 856992
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30