CMS Formulary

Displaying 131441-131450 of 1611142 results.
ID: 131441
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131442
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131443
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131444
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 131445
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 131446
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131447
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131448
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131449
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131450
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0