CMS Formulary

Displaying 133591-133600 of 1611142 results.
ID: 133591
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110513
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133592
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110516
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133593
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 133594
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133595
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133596
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133597
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133598
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 133599
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133600
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30