CMS Formulary

Displaying 135741-135750 of 1611142 results.
ID: 135741
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135742
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135743
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135744
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135745
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135746
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 722134
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135747
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 722137
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135748
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 722126
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135749
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 722131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135750
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30