CMS Formulary

Displaying 132761-132770 of 1611142 results.
ID: 132761
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861771
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132762
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132763
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132764
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132765
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 132766
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 132767
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 132768
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 132769
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 132770
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1