CMS Formulary

Displaying 133821-133830 of 1611142 results.
ID: 133821
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133822
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133823
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 133824
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133825
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133826
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133827
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133828
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133829
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133830
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0