CMS Formulary

Displaying 134361-134370 of 1611142 results.
ID: 134361
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134362
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134363
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134364
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134365
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134366
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 134367
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134368
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861025
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 765
Qty Limit Days: 30
ID: 134369
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 825005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 134370
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 881341
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0