CMS Formulary

Displaying 132401-132410 of 1611142 results.
ID: 132401
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132402
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 905158
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132403
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132404
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132405
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132406
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132407
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132408
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132409
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132410
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0