CMS Formulary

Displaying 187651-187660 of 1611142 results.
ID: 187651
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 187652
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 187653
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 187654
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 187655
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187656
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187657
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187658
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1653204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187659
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 351926
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187660
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30