CMS Formulary

Displaying 133091-133100 of 1611142 results.
ID: 133091
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 133092
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133093
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133094
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133095
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246313
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 133096
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246310
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 133097
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133098
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133099
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133100
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0