CMS Formulary

Displaying 135491-135500 of 1611142 results.
ID: 135491
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135492
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135493
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135494
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135495
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135496
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135497
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135498
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099870
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135499
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356563
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135500
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356572
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30