CMS Formulary

Displaying 130131-130140 of 1611142 results.
ID: 130131
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 130132
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 130133
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 130134
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130135
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130136
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130137
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130138
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130139
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 130140
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0