CMS Formulary

Displaying 133761-133770 of 1611142 results.
ID: 133761
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133762
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 750265
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133763
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762001
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133764
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133765
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133766
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133767
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133768
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133769
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133770
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0