CMS Formulary

Displaying 131461-131470 of 1611142 results.
ID: 131461
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131462
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131463
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131464
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131465
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131466
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131467
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131468
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 152
Qty Limit Days: 30
ID: 131469
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131470
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0