CMS Formulary

Displaying 134381-134390 of 1611142 results.
ID: 134381
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134382
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134383
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134384
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134385
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134386
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134387
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134388
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134389
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 134390
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28