CMS Formulary

Displaying 135321-135330 of 1611142 results.
ID: 135321
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135322
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135323
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135324
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135325
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135326
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135327
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135328
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135329
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135330
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0