CMS Formulary

Displaying 132561-132570 of 1611142 results.
ID: 132561
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132562
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132563
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132564
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132565
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132566
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132567
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 797061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132568
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 797065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132569
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 132570
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0