CMS Formulary

Displaying 132461-132470 of 1611142 results.
ID: 132461
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132462
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132463
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132464
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132465
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132466
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 132467
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132468
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132469
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132470
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0