CMS Formulary

Displaying 133861-133870 of 1611142 results.
ID: 133861
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133862
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133863
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133864
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133865
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133866
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359285
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133867
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133868
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359353
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133869
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359358
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133870
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0