CMS Formulary

Displaying 133071-133080 of 1611142 results.
ID: 133071
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2362244
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 133072
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133073
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133074
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133075
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133076
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133077
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133078
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 133079
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 133080
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28