CMS Formulary

Displaying 133581-133590 of 1611142 results.
ID: 133581
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 133582
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133583
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 209789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133584
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 209788
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133585
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133586
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133587
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133588
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133589
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 133590
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110510
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30