CMS Formulary

Displaying 131061-131070 of 1611142 results.
ID: 131061
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131062
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131063
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131064
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131065
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131066
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131067
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131068
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131069
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131070
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30