CMS Formulary

Displaying 134731-134740 of 1611142 results.
ID: 134731
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 134732
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134733
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134734
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134735
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134736
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134737
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134738
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134739
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134740
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0