CMS Formulary

Displaying 131051-131060 of 1611142 results.
ID: 131051
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131052
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131053
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131054
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131055
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131056
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131057
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131058
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131059
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131060
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30