CMS Formulary

Displaying 133551-133560 of 1611142 results.
ID: 133551
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133552
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133553
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133554
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133555
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133556
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133557
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133558
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133559
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133560
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28