CMS Formulary

Displaying 131271-131280 of 1611142 results.
ID: 131271
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131272
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 131273
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 131274
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 131275
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 131276
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 131277
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131278
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131279
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131280
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0