CMS Formulary

Displaying 185601-185610 of 1611142 results.
ID: 185601
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185602
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1232591
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 185603
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115012
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 185604
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1115013
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 185605
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185606
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185607
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185608
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185609
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 185610
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0