CMS Formulary

Displaying 135421-135430 of 1611142 results.
ID: 135421
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 135422
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135423
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135424
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135425
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135426
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135427
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135428
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135429
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135430
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0