CMS Formulary

Displaying 134331-134340 of 1611142 results.
ID: 134331
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134332
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134333
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134334
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134335
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134336
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134337
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905041
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134338
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 134339
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 134340
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 153822
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30