CMS Formulary

Displaying 131041-131050 of 1611142 results.
ID: 131041
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131042
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131043
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131044
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131045
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131046
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131047
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131048
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131049
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131050
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30