CMS Formulary

Displaying 132481-132490 of 1611142 results.
ID: 132481
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 132482
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132483
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132484
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132485
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132486
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132487
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132488
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132489
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132490
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 877417
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0