CMS Formulary

Displaying 133971-133980 of 1611142 results.
ID: 133971
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133972
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133973
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133974
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133975
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133976
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133977
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133978
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1233711
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133979
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013867
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133980
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30