CMS Formulary

Displaying 132891-132900 of 1611142 results.
ID: 132891
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132892
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132893
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132894
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132895
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132896
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132897
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132898
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 132899
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3600
Qty Limit Days: 30
ID: 132900
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30