CMS Formulary

Displaying 133481-133490 of 1611142 results.
ID: 133481
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133482
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133483
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133484
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133485
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133486
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133487
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133488
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133489
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133490
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30