CMS Formulary

Displaying 134221-134230 of 1611142 results.
ID: 134221
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134222
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134223
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134224
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134225
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134226
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134227
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 754512
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134228
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134229
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134230
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863603
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0