CMS Formulary

Displaying 133841-133850 of 1611142 results.
ID: 133841
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133842
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133843
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133844
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133845
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133846
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133847
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133848
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133849
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133850
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30