CMS Formulary

Displaying 133471-133480 of 1611142 results.
ID: 133471
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 133472
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133473
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133474
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133475
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133476
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133477
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133478
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133479
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133480
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30