CMS Formulary

Displaying 134031-134040 of 1611142 results.
ID: 134031
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012017
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134032
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 209002
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134033
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 208420
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134034
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134035
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134036
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134037
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134038
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010606
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134039
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307063
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134040
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0