CMS Formulary

Displaying 133051-133060 of 1611142 results.
ID: 133051
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133052
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133053
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133054
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133055
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133056
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 672152
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133057
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133058
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133059
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133060
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30