CMS Formulary

Displaying 133801-133810 of 1611142 results.
ID: 133801
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1080
Qty Limit Days: 30
ID: 133802
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133803
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133804
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133805
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133806
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133807
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133808
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133809
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133810
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0