CMS Formulary

Displaying 131291-131300 of 1611142 results.
ID: 131291
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131292
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131293
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131294
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131295
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131296
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131297
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131298
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131299
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131300
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0