CMS Formulary

Displaying 133711-133720 of 1611142 results.
ID: 133711
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133712
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311166
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133713
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133714
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133715
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 133716
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133717
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133718
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133719
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133720
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0