CMS Formulary

Displaying 135181-135190 of 1611142 results.
ID: 135181
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 135182
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 135183
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370982
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135184
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 809477
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135185
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135186
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135187
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135188
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135189
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135190
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0