CMS Formulary

Displaying 186801-186810 of 1611142 results.
ID: 186801
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186802
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186803
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186804
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186805
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1053697
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 28
ID: 186806
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 197849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186807
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1487363
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 186808
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186809
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186810
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0