CMS Formulary

Displaying 130521-130530 of 1611142 results.
ID: 130521
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130522
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130523
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130524
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130525
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130526
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 130527
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 130528
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130529
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 130530
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0