CMS Formulary

Displaying 135271-135280 of 1611142 results.
ID: 135271
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135272
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135273
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135274
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135275
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135276
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135277
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135278
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135279
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135280
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0