CMS Formulary

Displaying 133341-133350 of 1611142 results.
ID: 133341
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133342
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133343
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133344
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133345
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133346
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133347
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133348
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133349
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133350
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0