CMS Formulary

Displaying 134631-134640 of 1611142 results.
ID: 134631
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134632
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134633
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134634
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134635
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351276
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134636
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134637
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134638
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 134639
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134640
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0