CMS Formulary

Displaying 131111-131120 of 1611142 results.
ID: 131111
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131112
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131113
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 131114
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131115
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131116
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131117
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131118
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131119
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131120
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0