CMS Formulary

Displaying 133111-133120 of 1611142 results.
ID: 133111
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133112
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133113
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198107
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133114
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133115
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133116
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133117
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133118
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133119
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133120
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0