CMS Formulary

Displaying 132261-132270 of 1611142 results.
ID: 132261
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132262
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132263
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132264
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 132265
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132266
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 132267
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 132268
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132269
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132270
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0