CMS Formulary

Displaying 131581-131590 of 1611142 results.
ID: 131581
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131582
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131583
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131584
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131585
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131586
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131587
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131588
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131589
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131590
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0