CMS Formulary

Displaying 135601-135610 of 1611142 results.
ID: 135601
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 794641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135602
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 902624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135603
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 902626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135604
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135605
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790892
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135606
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790886
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135607
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790890
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135608
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2384465
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 28
ID: 135609
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670324
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135610
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30