CMS Formulary

Displaying 132521-132530 of 1611142 results.
ID: 132521
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 315090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132522
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132523
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132524
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 132525
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132526
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132527
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132528
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132529
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 132530
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0