CMS Formulary

Displaying 133391-133400 of 1611142 results.
ID: 133391
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133392
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 999965
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133393
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133394
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133395
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601982
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133396
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133397
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133398
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 244098
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133399
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 245220
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133400
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 800928
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0