CMS Formulary

Displaying 187061-187070 of 1611142 results.
ID: 187061
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187062
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187063
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187064
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187065
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187066
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187067
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187068
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 1989117
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 187069
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 2178792
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 187070
Formulary ID: 00021080
Formulary Version: 13
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0