CMS Formulary

Displaying 132331-132340 of 1611142 results.
ID: 132331
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132332
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132333
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132334
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132335
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132336
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132337
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132338
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132339
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132340
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30