CMS Formulary

Displaying 133731-133740 of 1611142 results.
ID: 133731
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133732
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133733
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133734
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133735
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133736
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133737
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133738
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133739
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133740
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30