CMS Formulary

Displaying 131921-131930 of 1611142 results.
ID: 131921
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131922
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131923
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131924
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131925
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131926
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131927
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131928
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131929
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131930
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0