CMS Formulary

Displaying 131091-131100 of 1611142 results.
ID: 131091
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131092
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131093
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 131094
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131095
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131096
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131097
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131098
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131099
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131100
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0