CMS Formulary

Displaying 133691-133700 of 1611142 results.
ID: 133691
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133692
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133693
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133694
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133695
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133696
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133697
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133698
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133699
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 133700
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0