CMS Formulary

Displaying 134491-134500 of 1611142 results.
ID: 134491
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134492
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134493
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134494
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134495
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134496
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134497
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134498
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134499
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 134500
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0