CMS Formulary

Displaying 132201-132210 of 1611142 results.
ID: 132201
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132202
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132203
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132204
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132205
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132206
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132207
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 132208
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 582595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 210
Qty Limit Days: 30
ID: 132209
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861966
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132210
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488667
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0