CMS Formulary

Displaying 131961-131970 of 1611142 results.
ID: 131961
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131962
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131963
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131964
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131965
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131966
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131967
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131968
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 131969
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131970
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0