CMS Formulary

Displaying 132581-132590 of 1611142 results.
ID: 132581
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132582
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132583
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132584
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132585
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132586
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132587
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132588
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132589
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 132590
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30