CMS Formulary

Displaying 133151-133160 of 1611142 results.
ID: 133151
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133152
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133153
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133154
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133155
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 133156
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133157
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905032
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133158
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133159
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133160
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0