CMS Formulary

Displaying 134811-134820 of 1611142 results.
ID: 134811
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134812
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134813
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134814
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 134815
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134816
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134817
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134818
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134819
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134820
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0