CMS Formulary

Displaying 134081-134090 of 1611142 results.
ID: 134081
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134082
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134083
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134084
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134085
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134086
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134087
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134088
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134089
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134090
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28