CMS Formulary

Displaying 132741-132750 of 1611142 results.
ID: 132741
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132742
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132743
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132744
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132745
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 132746
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132747
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132748
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132749
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132750
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30