CMS Formulary

Displaying 134041-134050 of 1611142 results.
ID: 134041
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 134042
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134043
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134044
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134045
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134046
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 134047
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 134048
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 134049
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134050
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0