CMS Formulary

Displaying 134351-134360 of 1611142 results.
ID: 134351
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134352
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134353
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 134354
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134355
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134356
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058845
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134357
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134358
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134359
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134360
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0