CMS Formulary

Displaying 134691-134700 of 1611142 results.
ID: 134691
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 134692
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 134693
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134694
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 134695
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134696
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134697
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134698
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134699
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134700
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30