CMS Formulary

Displaying 132411-132420 of 1611142 results.
ID: 132411
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132412
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 132413
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132414
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 132415
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 132416
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132417
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132418
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132419
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132420
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0