CMS Formulary

Displaying 135101-135110 of 1611142 results.
ID: 135101
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 135102
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135103
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 135104
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 135105
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 135106
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 135107
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135108
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 135109
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 135110
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1