CMS Formulary

Displaying 135041-135050 of 1611142 results.
ID: 135041
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135042
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135043
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135044
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135045
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135046
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135047
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135048
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135049
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135050
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30