CMS Formulary

Displaying 132051-132060 of 1611142 results.
ID: 132051
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132052
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132053
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132054
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132055
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132056
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132057
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132058
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132059
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132060
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28