CMS Formulary

Displaying 134941-134950 of 1611142 results.
ID: 134941
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 134942
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 580286
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 134943
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134944
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134945
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134946
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134947
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134948
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 134949
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134950
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0