CMS Formulary

Displaying 135141-135150 of 1611142 results.
ID: 135141
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135142
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135143
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135144
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135145
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135146
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309889
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135147
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 745752
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135148
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135149
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1593858
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135150
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854832
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0