CMS Formulary

Displaying 135051-135060 of 1611142 results.
ID: 135051
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135052
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135053
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135054
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135055
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135056
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 135057
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 135058
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135059
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135060
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0