CMS Formulary

Displaying 132061-132070 of 1611142 results.
ID: 132061
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 132062
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 132063
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132064
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132065
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132066
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132067
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132068
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132069
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 132070
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30