CMS Formulary

Displaying 131981-131990 of 1611142 results.
ID: 131981
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131982
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131983
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 131984
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131985
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131986
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 131987
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 131988
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 131989
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1726639
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131990
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30