CMS Formulary

Displaying 135791-135800 of 1611142 results.
ID: 135791
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135792
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135793
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135794
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135795
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135796
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135797
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135798
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135799
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135800
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0