CMS Formulary

Displaying 135591-135600 of 1611142 results.
ID: 135591
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135592
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135593
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135594
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135595
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135596
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135597
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373493
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135598
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135599
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135600
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 858804
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30