CMS Formulary

Displaying 131521-131530 of 1611142 results.
ID: 131521
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131522
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131523
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131524
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131525
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131526
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131527
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 131528
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131529
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131530
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0