CMS Formulary

Displaying 132871-132880 of 1611142 results.
ID: 132871
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132872
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132873
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132874
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132875
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132876
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132877
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132878
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132879
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 132880
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3900
Qty Limit Days: 30