CMS Formulary

Displaying 135121-135130 of 1611142 results.
ID: 135121
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135122
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135123
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135124
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135125
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135126
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135127
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135128
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135129
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135130
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0