CMS Formulary

Displaying 135641-135650 of 1611142 results.
ID: 135641
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135642
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135643
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135644
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135645
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135646
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135647
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135648
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135649
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135650
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0