CMS Formulary

Displaying 131311-131320 of 1611142 results.
ID: 131311
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131312
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131313
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131314
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131315
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131316
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131317
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131318
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131319
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2059017
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131320
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1232084
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30