CMS Formulary

Displaying 131491-131500 of 1611142 results.
ID: 131491
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131492
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131493
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131494
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131495
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131496
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 131497
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131498
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131499
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131500
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0