CMS Formulary

Displaying 133981-133990 of 1611142 results.
ID: 133981
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 133982
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854238
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 36
Qty Limit Days: 30
ID: 133983
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 133984
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854248
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133985
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854245
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 48
Qty Limit Days: 30
ID: 133986
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133987
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133988
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133989
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133990
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0