CMS Formulary

Displaying 133511-133520 of 1611142 results.
ID: 133511
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133512
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133513
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133514
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133515
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133516
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133517
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133518
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133519
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133520
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0