CMS Formulary

Displaying 134561-134570 of 1611142 results.
ID: 134561
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 780
Qty Limit Days: 30
ID: 134562
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134563
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134564
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134565
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134566
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 134567
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134568
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134569
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 134570
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1