CMS Formulary

Displaying 132651-132660 of 1611142 results.
ID: 132651
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 132652
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 132653
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132654
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132655
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132656
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1594673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132657
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132658
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132659
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132660
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0