CMS Formulary

Displaying 133361-133370 of 1611142 results.
ID: 133361
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 133362
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133363
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133364
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133365
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133366
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133367
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133368
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133369
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133370
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0