CMS Formulary

Displaying 133311-133320 of 1611142 results.
ID: 133311
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133312
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133313
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133314
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133315
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133316
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133317
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133318
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133319
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 133320
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30