CMS Formulary

Displaying 134881-134890 of 1611142 results.
ID: 134881
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134882
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134883
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 134884
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 134885
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 134886
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134887
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134888
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134889
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134890
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0