CMS Formulary

Displaying 135451-135460 of 1611142 results.
ID: 135451
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135452
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135453
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135454
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135455
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135456
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135457
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135458
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135459
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135460
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30