CMS Formulary

Displaying 133411-133420 of 1611142 results.
ID: 133411
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133412
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133413
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133414
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133415
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133416
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133417
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133418
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133419
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133420
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790644
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30