CMS Formulary

Displaying 131131-131140 of 1611142 results.
ID: 131131
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131132
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131133
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131134
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131135
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131136
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131137
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131138
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131139
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131140
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30