CMS Formulary

Displaying 134771-134780 of 1611142 results.
ID: 134771
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134772
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134773
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134774
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134775
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134776
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134777
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134778
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193349
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134779
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193353
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134780
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2359344
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30