CMS Formulary

Displaying 133301-133310 of 1611142 results.
ID: 133301
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133302
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133303
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133304
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133305
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133306
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133307
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133308
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133309
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133310
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30