CMS Formulary

Displaying 131861-131870 of 1611142 results.
ID: 131861
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131862
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131863
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131864
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131865
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131866
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131867
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 131868
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131869
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131870
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30