CMS Formulary

Displaying 132851-132860 of 1611142 results.
ID: 132851
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132852
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132853
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 132854
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 991722
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132855
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132856
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132857
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132858
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132859
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132860
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30