CMS Formulary

Displaying 186721-186730 of 1611142 results.
ID: 186721
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 359500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186722
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186723
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186724
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 186725
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186726
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 833234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186727
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186728
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186729
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186730
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0