CMS Formulary

Displaying 134281-134290 of 1611142 results.
ID: 134281
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134282
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134283
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134284
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134285
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134286
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134287
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134288
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134289
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134290
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30