CMS Formulary

Displaying 134581-134590 of 1611142 results.
ID: 134581
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 134582
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 134583
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134584
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134585
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134586
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 134587
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 134588
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 134589
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001430
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134590
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30