CMS Formulary

Displaying 135461-135470 of 1611142 results.
ID: 135461
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135462
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135463
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135464
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135465
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135466
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135467
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135468
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135469
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135470
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0