CMS Formulary

Displaying 134761-134770 of 1611142 results.
ID: 134761
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134762
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 724142
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134763
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134764
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134765
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 134766
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134767
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134768
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134769
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134770
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0