CMS Formulary

Displaying 186021-186030 of 1611142 results.
ID: 186021
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 485486
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186022
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 485485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186023
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 485484
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186024
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310818
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186025
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 259255
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186026
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 905028
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 186027
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 905024
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 186028
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 577208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186029
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 205328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186030
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30