CMS Formulary

Displaying 131631-131640 of 1611142 results.
ID: 131631
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131632
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131633
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 131634
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 131635
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131636
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131637
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131638
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131639
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131640
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0