CMS Formulary

Displaying 135691-135700 of 1611142 results.
ID: 135691
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135692
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135693
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135694
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135695
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135696
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135697
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135698
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135699
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135700
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30