CMS Formulary

Displaying 132271-132280 of 1611142 results.
ID: 132271
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132272
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132273
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132274
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 132275
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132276
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132277
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132278
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132279
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 849833
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132280
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30