CMS Formulary

Displaying 131031-131040 of 1611142 results.
ID: 131031
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131032
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131033
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 131034
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131035
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131036
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131037
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131038
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131039
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131040
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0