CMS Formulary

Displaying 132021-132030 of 1611142 results.
ID: 132021
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132022
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132023
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132024
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861379
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132025
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132026
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1743549
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132027
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132028
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132029
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371050
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 132030
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30