CMS Formulary

Displaying 133941-133950 of 1611142 results.
ID: 133941
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133942
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133943
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133944
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133945
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133946
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 133947
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133948
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133949
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 133950
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0