CMS Formulary

Displaying 134831-134840 of 1611142 results.
ID: 134831
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134832
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134833
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134834
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134835
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 134836
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134837
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134838
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310247
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134839
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134840
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0