CMS Formulary

Displaying 134411-134420 of 1611142 results.
ID: 134411
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134412
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134413
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134414
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134415
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134416
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134417
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134418
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134419
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134420
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0