CMS Formulary

Displaying 135311-135320 of 1611142 results.
ID: 135311
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135312
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135313
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135314
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135315
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135316
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135317
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135318
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135319
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135320
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30