CMS Formulary

Displaying 186561-186570 of 1611142 results.
ID: 186561
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186562
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 186563
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186564
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186565
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 186566
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 186567
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186568
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186569
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28
ID: 186570
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 28