CMS Formulary

Displaying 135651-135660 of 1611142 results.
ID: 135651
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135652
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135653
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 750
Qty Limit Days: 30
ID: 135654
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 135655
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135656
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 825134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135657
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135658
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135659
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135660
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0