CMS Formulary

Displaying 133611-133620 of 1611142 results.
ID: 133611
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133612
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133613
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133614
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 133615
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 133616
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 133617
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 133618
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133619
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133620
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0