CMS Formulary

Displaying 131991-132000 of 1611142 results.
ID: 131991
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364358
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 131992
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131993
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049271
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131994
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049278
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 131995
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131996
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 284215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131997
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658221
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131998
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 544840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131999
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 132000
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0