CMS Formulary

Displaying 133851-133860 of 1611142 results.
ID: 133851
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133852
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 133853
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133854
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 133855
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133856
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133857
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133858
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133859
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133860
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30