CMS Formulary

Displaying 131821-131830 of 1611142 results.
ID: 131821
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966246
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131822
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131823
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966243
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131824
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 131825
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 131826
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 131827
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131828
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131829
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131830
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0