CMS Formulary

Displaying 134511-134520 of 1611142 results.
ID: 134511
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 134512
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134513
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134514
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134515
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134516
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134517
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134518
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134519
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 134520
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0