CMS Formulary

Displaying 135061-135070 of 1611142 results.
ID: 135061
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135062
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135063
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135064
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135065
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135066
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135067
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135068
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135069
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135070
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0