CMS Formulary

Displaying 131971-131980 of 1611142 results.
ID: 131971
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1092360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131972
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131973
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131974
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131975
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131976
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131977
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131978
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131979
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131980
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30