CMS Formulary

Displaying 186331-186340 of 1611142 results.
ID: 186331
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1368020
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186332
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186333
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186334
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186335
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 186336
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186337
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186338
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1737789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186339
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 309952
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186340
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197622
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0