CMS Formulary

Displaying 132301-132310 of 1611142 results.
ID: 132301
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 132302
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132303
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132304
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132305
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132306
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132307
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132308
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132309
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132310
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0