CMS Formulary

Displaying 134151-134160 of 1611142 results.
ID: 134151
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134152
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134153
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134154
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134155
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134156
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134157
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134158
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134159
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134160
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0