CMS Formulary

Displaying 133641-133650 of 1611142 results.
ID: 133641
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133642
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133643
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133644
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133645
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133646
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133647
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133648
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133649
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133650
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30