CMS Formulary

Displaying 134911-134920 of 1611142 results.
ID: 134911
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134912
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134913
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134914
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 152
Qty Limit Days: 30
ID: 134915
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134916
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134917
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134918
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134919
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134920
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0