CMS Formulary

Displaying 132491-132500 of 1611142 results.
ID: 132491
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132492
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132493
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132494
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132495
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132496
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132497
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132498
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 132499
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 132500
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0