CMS Formulary

Displaying 131681-131690 of 1611142 results.
ID: 131681
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 794610
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131682
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831870
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131683
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 850457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 131684
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1236632
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 400
Qty Limit Days: 30
ID: 131685
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131686
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 758555
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131687
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1052660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131688
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1250723
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131689
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600710
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131690
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999587
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30