CMS Formulary

Displaying 135391-135400 of 1611142 results.
ID: 135391
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135392
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135393
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135394
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135395
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135396
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135397
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135398
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135399
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135400
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30