CMS Formulary

Displaying 132231-132240 of 1611142 results.
ID: 132231
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132232
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132233
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132234
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132235
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132236
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132237
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132238
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132239
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490032
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132240
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490036
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30