CMS Formulary

Displaying 130621-130630 of 1611142 results.
ID: 130621
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 130622
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 130623
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130624
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 130625
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130626
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130627
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130628
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130629
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130630
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0