CMS Formulary

Displaying 187101-187110 of 1611142 results.
ID: 187101
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 847254
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187102
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 847213
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187103
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1652640
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187104
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 847189
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187105
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 847199
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187106
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187107
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187108
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187109
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187110
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30