CMS Formulary

Displaying 132151-132160 of 1611142 results.
ID: 132151
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132152
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132153
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132154
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132155
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132156
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132157
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132158
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132159
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132160
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0