CMS Formulary

Displaying 132351-132360 of 1611142 results.
ID: 132351
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132352
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132353
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132354
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132355
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132356
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132357
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132358
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132359
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132360
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30