CMS Formulary

Displaying 132251-132260 of 1611142 results.
ID: 132251
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132252
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132253
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132254
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132255
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132256
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132257
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132258
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132259
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132260
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0