CMS Formulary

Displaying 131171-131180 of 1611142 results.
ID: 131171
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131172
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131173
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131174
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131175
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131176
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131177
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131178
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131179
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 131180
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30