CMS Formulary

Displaying 131121-131130 of 1611142 results.
ID: 131121
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131122
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131123
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131124
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131125
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131126
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 131127
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131128
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131129
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131130
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0