CMS Formulary

Displaying 134021-134030 of 1611142 results.
ID: 134021
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 134022
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134023
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 134024
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134025
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134026
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134027
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134028
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134029
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091133
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 134030
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0