CMS Formulary

Displaying 135501-135510 of 1611142 results.
ID: 135501
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356576
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135502
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135503
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135504
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135505
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 135506
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135507
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135508
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1092360
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135509
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135510
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0