CMS Formulary

Displaying 186911-186920 of 1611142 results.
ID: 186911
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186912
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1798375
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186913
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 186914
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 186915
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186916
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186917
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1867544
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186918
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186919
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2107518
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186920
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0