CMS Formulary

Displaying 134061-134070 of 1611142 results.
ID: 134061
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134062
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134063
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134064
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134065
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134066
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134067
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134068
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134069
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134070
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30