CMS Formulary

Displaying 132291-132300 of 1611142 results.
ID: 132291
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132292
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653221
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132293
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132294
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132295
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132296
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132297
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132298
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132299
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132300
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30