CMS Formulary

Displaying 132101-132110 of 1611142 results.
ID: 132101
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 825134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132102
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132103
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132104
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132105
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132106
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132107
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132108
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132109
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132110
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0