CMS Formulary

Displaying 132091-132100 of 1611142 results.
ID: 132091
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132092
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132093
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132094
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132095
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132096
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132097
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132098
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 750
Qty Limit Days: 30
ID: 132099
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 132100
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30