CMS Formulary

Displaying 186931-186940 of 1611142 results.
ID: 186931
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186932
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1872458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186933
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 186934
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 186935
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186936
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1537045
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186937
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186938
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186939
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 799040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 186940
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 799037
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30