CMS Formulary

Displaying 132681-132690 of 1611142 results.
ID: 132681
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132682
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132683
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132684
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132685
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132686
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132687
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 132688
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 132689
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 132690
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28