CMS Formulary

Displaying 131141-131150 of 1611142 results.
ID: 131141
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131142
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131143
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131144
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131145
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131146
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131147
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131148
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131149
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131150
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30