CMS Formulary

Displaying 133351-133360 of 1611142 results.
ID: 133351
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 133352
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 133353
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133354
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133355
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859192
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133356
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133357
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133358
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133359
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133360
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30