CMS Formulary

Displaying 131341-131350 of 1611142 results.
ID: 131341
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131342
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131343
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131344
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131345
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131346
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131347
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131348
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131349
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131350
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30