CMS Formulary

Displaying 132641-132650 of 1611142 results.
ID: 132641
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132642
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132643
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 132644
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 132645
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 132646
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132647
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132648
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 132649
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1591943
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132650
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28