CMS Formulary

Displaying 135681-135690 of 1611142 results.
ID: 135681
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135682
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135683
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135684
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135685
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135686
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 135687
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 135688
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 135689
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135690
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30