CMS Formulary

Displaying 132751-132760 of 1611142 results.
ID: 132751
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132752
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132753
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132754
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132755
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132756
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547118
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132757
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235595
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132758
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235591
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132759
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 668606
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132760
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861821
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30