CMS Formulary

Displaying 134291-134300 of 1611142 results.
ID: 134291
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134292
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134293
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134294
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134295
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134296
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134297
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134298
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134299
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134300
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0