CMS Formulary

Displaying 186371-186380 of 1611142 results.
ID: 186371
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186372
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186373
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 186374
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186375
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186376
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186377
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186378
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 2160
Qty Limit Days: 30
ID: 186379
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186380
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0