CMS Formulary

Displaying 134341-134350 of 1611142 results.
ID: 134341
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 153823
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134342
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 639537
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134343
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 578325
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134344
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 578330
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134345
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 802749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134346
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134347
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134348
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134349
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134350
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0