CMS Formulary

Displaying 134971-134980 of 1611142 results.
ID: 134971
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312836
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134972
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311277
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134973
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099563
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134974
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904932
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 134975
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313758
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134976
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 134977
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134978
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134979
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134980
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0