CMS Formulary

Displaying 132241-132250 of 1611142 results.
ID: 132241
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132242
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132243
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132244
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132245
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132246
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132247
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132248
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132249
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132250
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0