CMS Formulary

Displaying 134091-134100 of 1611142 results.
ID: 134091
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134092
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134093
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 797697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134094
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134095
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855906
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134096
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134097
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134098
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134099
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134100
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0