CMS Formulary

Displaying 134171-134180 of 1611142 results.
ID: 134171
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134172
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134173
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134174
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134175
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134176
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134177
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134178
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134179
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 134180
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30