CMS Formulary

Displaying 132611-132620 of 1611142 results.
ID: 132611
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099323
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132612
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132613
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132614
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132615
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132616
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132617
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132618
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132619
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 132620
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28