CMS Formulary

Displaying 186991-187000 of 1611142 results.
ID: 186991
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186992
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 186993
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186994
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186995
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186996
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186997
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 186998
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 186999
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 187000
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30