CMS Formulary

Displaying 135441-135450 of 1611142 results.
ID: 135441
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854868
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135442
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135443
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135444
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135445
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135446
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135447
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135448
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135449
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135450
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30