CMS Formulary

Displaying 133931-133940 of 1611142 results.
ID: 133931
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133932
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133933
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133934
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 810090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133935
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403851
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133936
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 810083
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133937
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133938
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 730988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133939
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349556
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133940
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 240741
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0