CMS Formulary

Displaying 131591-131600 of 1611142 results.
ID: 131591
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131592
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131593
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 131594
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 131595
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 131596
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131597
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131598
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131599
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131600
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30