CMS Formulary

Displaying 135401-135410 of 1611142 results.
ID: 135401
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135402
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135403
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 850
Qty Limit Days: 30
ID: 135404
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135405
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135406
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135407
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135408
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135409
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1147337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135410
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1306298
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30