CMS Formulary

Displaying 132721-132730 of 1611142 results.
ID: 132721
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 847189
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132722
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 847199
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132723
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1731317
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132724
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643177
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132725
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643173
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132726
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132727
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132728
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132729
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132730
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30