CMS Formulary

Displaying 134051-134060 of 1611142 results.
ID: 134051
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134052
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134053
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 134054
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134055
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134056
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134057
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134058
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134059
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134060
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0