CMS Formulary

Displaying 135411-135420 of 1611142 results.
ID: 135411
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1551999
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135412
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135413
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2203999
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135414
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2204092
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135415
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544471
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135416
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135417
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135418
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135419
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135420
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28