CMS Formulary

Displaying 134791-134800 of 1611142 results.
ID: 134791
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 134792
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 134793
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 134794
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134795
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284592
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134796
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284594
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134797
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134798
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284595
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134799
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134800
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0