CMS Formulary

Displaying 187131-187140 of 1611142 results.
ID: 187131
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187132
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 187133
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187134
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187135
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187136
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187137
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 904465
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 187138
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187139
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187140
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0