CMS Formulary

Displaying 131611-131620 of 1611142 results.
ID: 131611
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100075
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131612
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131613
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131614
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131615
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131616
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131617
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131618
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131619
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131620
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1