CMS Formulary

Displaying 134601-134610 of 1611142 results.
ID: 134601
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134602
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134603
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134604
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134605
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1840
Qty Limit Days: 30
ID: 134606
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134607
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134608
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134609
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 134610
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0