CMS Formulary

Displaying 133601-133610 of 1611142 results.
ID: 133601
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133602
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133603
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133604
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133605
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133606
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 133607
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 133608
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133609
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 133610
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30