CMS Formulary

Displaying 133241-133250 of 1611142 results.
ID: 133241
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133242
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133243
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133244
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133245
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133246
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133247
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133248
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133249
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133250
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5400
Qty Limit Days: 30