CMS Formulary

Displaying 135511-135520 of 1611142 results.
ID: 135511
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135512
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135513
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135514
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135515
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135516
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135517
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 135518
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135519
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135520
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30