CMS Formulary

Displaying 131481-131490 of 1611142 results.
ID: 131481
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131482
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716215
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131483
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716219
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131484
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131485
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131486
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131487
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131488
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131489
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131490
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0