CMS Formulary

Displaying 132451-132460 of 1611142 results.
ID: 132451
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132452
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132453
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132454
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132455
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132456
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132457
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132458
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132459
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132460
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0