CMS Formulary

Displaying 131881-131890 of 1611142 results.
ID: 131881
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131882
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131883
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131884
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1591949
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131885
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2204104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131886
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2204102
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131887
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131888
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131889
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131890
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28