CMS Formulary

Displaying 133031-133040 of 1611142 results.
ID: 133031
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133032
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133033
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133034
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133035
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133036
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133037
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133038
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133039
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 133040
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30