CMS Formulary

Displaying 132961-132970 of 1611142 results.
ID: 132961
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 132962
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132963
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132964
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132965
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132966
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132967
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132968
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132969
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132970
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0