CMS Formulary

Displaying 131651-131660 of 1611142 results.
ID: 131651
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131652
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131653
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131654
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131655
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131656
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131657
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131658
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 643714
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131659
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131660
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30