CMS Formulary

Displaying 133201-133210 of 1611142 results.
ID: 133201
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133202
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133203
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133204
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133205
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133206
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133207
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133208
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133209
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133210
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0