CMS Formulary

Displaying 135751-135760 of 1611142 results.
ID: 135751
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135752
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135753
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135754
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135755
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135756
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135757
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135758
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135759
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135760
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30