CMS Formulary

Displaying 132391-132400 of 1611142 results.
ID: 132391
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132392
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132393
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132394
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132395
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 132396
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132397
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132398
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 132399
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132400
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30