CMS Formulary

Displaying 132861-132870 of 1611142 results.
ID: 132861
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132862
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132863
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132864
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132865
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132866
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3000
Qty Limit Days: 30
ID: 132867
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 132868
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 997170
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132869
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132870
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30