CMS Formulary

Displaying 132181-132190 of 1611142 results.
ID: 132181
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132182
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132183
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132184
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132185
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132186
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132187
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132188
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132189
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132190
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0