CMS Formulary

Displaying 135631-135640 of 1611142 results.
ID: 135631
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135632
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797113
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135633
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135634
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135635
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135636
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135637
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135638
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135639
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135640
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0