CMS Formulary

Displaying 131891-131900 of 1611142 results.
ID: 131891
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 131892
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131893
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131894
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131895
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131896
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131897
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131898
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131899
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131900
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0