CMS Formulary

Displaying 135071-135080 of 1611142 results.
ID: 135071
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135072
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205329
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 135073
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205330
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135074
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205331
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135075
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135076
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135077
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135078
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135079
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135080
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0