CMS Formulary

Displaying 132981-132990 of 1611142 results.
ID: 132981
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132982
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132983
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132984
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132985
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132986
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132987
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132988
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855871
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132989
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132990
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0