CMS Formulary

Displaying 132691-132700 of 1611142 results.
ID: 132691
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 132692
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2370174
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132693
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2170613
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 132694
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2395785
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 132695
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2370170
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132696
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946836
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132697
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132698
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132699
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132700
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30