CMS Formulary

Displaying 134461-134470 of 1611142 results.
ID: 134461
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134462
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134463
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134464
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134465
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 401938
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134466
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751566
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134467
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751568
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134468
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751570
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134469
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 758032
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 134470
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 758027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28