CMS Formulary

Displaying 133531-133540 of 1611142 results.
ID: 133531
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133532
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133533
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313366
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133534
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000070
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133535
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536586
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133536
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 242333
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 133537
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 241527
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 133538
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403922
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 133539
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402109
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133540
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855875
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0