CMS Formulary

Displaying 133811-133820 of 1611142 results.
ID: 133811
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133812
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 828299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133813
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133814
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133815
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133816
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133817
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133818
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133819
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133820
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0