CMS Formulary

Displaying 132661-132670 of 1611142 results.
ID: 132661
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132662
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132663
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 525
Qty Limit Days: 30
ID: 132664
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132665
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132666
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132667
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132668
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132669
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132670
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0