CMS Formulary

Displaying 133431-133440 of 1611142 results.
ID: 133431
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 133432
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861045
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133433
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861043
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133434
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133435
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133436
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133437
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133438
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133439
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133440
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0