CMS Formulary

Displaying 134891-134900 of 1611142 results.
ID: 134891
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134892
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134893
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134894
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134895
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134896
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134897
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134898
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134899
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134900
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0