CMS Formulary

Displaying 133501-133510 of 1611142 results.
ID: 133501
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133502
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133503
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133504
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133505
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133506
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133507
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133508
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133509
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133510
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30