CMS Formulary

Displaying 134441-134450 of 1611142 results.
ID: 134441
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134442
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134443
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134444
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404013
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134445
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404011
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134446
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597990
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134447
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597984
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134448
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597993
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134449
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597967
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134450
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 597980
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30