CMS Formulary

Displaying 133661-133670 of 1611142 results.
ID: 133661
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133662
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133663
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133664
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133665
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133666
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133667
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133668
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133669
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133670
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30