CMS Formulary

Displaying 131941-131950 of 1611142 results.
ID: 131941
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131942
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131943
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131944
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131945
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476349
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131946
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476350
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131947
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131948
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131949
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131950
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30