CMS Formulary

Displaying 133081-133090 of 1611142 results.
ID: 133081
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 133082
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 133083
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 133084
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123314
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133085
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121096
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 133086
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121100
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 133087
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133088
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133089
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133090
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30