CMS Formulary

Displaying 131511-131520 of 1611142 results.
ID: 131511
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131512
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131513
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313778
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131514
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131515
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131516
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314215
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131517
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131518
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131519
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131520
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28