CMS Formulary

Displaying 132431-132440 of 1611142 results.
ID: 132431
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132432
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132433
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132434
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132435
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132436
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132437
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132438
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132439
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132440
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0