CMS Formulary

Displaying 132321-132330 of 1611142 results.
ID: 132321
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132322
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132323
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132324
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132325
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132326
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132327
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132328
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132329
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132330
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30