CMS Formulary

Displaying 132161-132170 of 1611142 results.
ID: 132161
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132162
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132163
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132164
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132165
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132166
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132167
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132168
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132169
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132170
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30