CMS Formulary

Displaying 132071-132080 of 1611142 results.
ID: 132071
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132072
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132073
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132074
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132075
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132076
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132077
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132078
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132079
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132080
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0