CMS Formulary

Displaying 135351-135360 of 1611142 results.
ID: 135351
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966246
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135352
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135353
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966243
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135354
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 135355
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 135356
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 135357
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135358
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135359
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135360
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0