CMS Formulary

Displaying 135671-135680 of 1611142 results.
ID: 135671
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135672
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135673
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135674
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135675
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135676
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135677
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1920
Qty Limit Days: 30
ID: 135678
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 135679
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135680
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0