CMS Formulary

Displaying 132471-132480 of 1611142 results.
ID: 132471
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 132472
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132473
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 132474
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 132475
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 132476
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132477
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132478
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132479
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132480
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0