CMS Formulary

Displaying 131161-131170 of 1611142 results.
ID: 131161
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131162
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131163
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131164
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131165
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131166
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131167
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131168
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131169
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131170
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1