CMS Formulary

Displaying 186391-186400 of 1611142 results.
ID: 186391
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1873765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186392
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 186393
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186394
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186395
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186396
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186397
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186398
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186399
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186400
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0