CMS Formulary

Displaying 186681-186690 of 1611142 results.
ID: 186681
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186682
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1599949
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 186683
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186684
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 17
Qty Limit Days: 30
ID: 186685
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186686
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186687
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186688
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186689
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186690
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30