CMS Formulary

Displaying 134131-134140 of 1611142 results.
ID: 134131
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134132
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134133
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134134
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134135
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134136
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134137
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134138
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134139
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134140
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30