CMS Formulary

Displaying 135711-135720 of 1611142 results.
ID: 135711
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135712
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135713
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135714
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135715
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135716
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135717
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135718
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135719
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135720
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0