CMS Formulary

Displaying 131501-131510 of 1611142 results.
ID: 131501
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131502
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131503
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131504
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131505
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131506
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131507
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131508
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131509
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131510
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30