CMS Formulary

Displaying 134011-134020 of 1611142 results.
ID: 134011
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134012
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134013
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134014
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134015
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134016
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134017
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134018
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134019
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134020
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0