CMS Formulary

Displaying 132371-132380 of 1611142 results.
ID: 132371
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132372
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132373
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132374
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132375
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132376
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132377
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132378
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132379
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132380
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30