CMS Formulary

Displaying 130541-130550 of 1611142 results.
ID: 130541
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130542
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130543
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197363
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130544
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130545
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197383
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130546
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130547
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 380
Qty Limit Days: 30
ID: 130548
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 130549
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 20
ID: 130550
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0