CMS Formulary

Displaying 187711-187720 of 1611142 results.
ID: 187711
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 187712
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 187713
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187714
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187715
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 966524
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 187716
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 966529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 187717
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1297660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187718
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 1297763
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 187719
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 998426
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 187720
Formulary ID: 00021081
Formulary Version: 13
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0