CMS Formulary

Displaying 134671-134680 of 1611142 results.
ID: 134671
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134672
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134673
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134674
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134675
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134676
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134677
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134678
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134679
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134680
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30