CMS Formulary

Displaying 131191-131200 of 1611142 results.
ID: 131191
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131192
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131193
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131194
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131195
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131196
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131197
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131198
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1840
Qty Limit Days: 30
ID: 131199
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131200
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30