CMS Formulary

Displaying 133521-133530 of 1611142 results.
ID: 133521
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133522
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133523
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133524
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133525
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133526
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 606726
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133527
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 606730
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133528
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133529
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133530
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0