CMS Formulary

Displaying 134101-134110 of 1611142 results.
ID: 134101
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134102
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134103
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134104
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134105
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134106
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134107
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134108
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134109
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134110
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30