CMS Formulary

Displaying 134231-134240 of 1611142 results.
ID: 134231
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134232
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134233
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134234
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134235
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134236
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134237
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134238
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134239
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134240
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30