CMS Formulary

Displaying 132941-132950 of 1611142 results.
ID: 132941
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132942
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132943
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132944
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132945
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132946
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132947
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132948
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132949
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132950
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30