CMS Formulary

Displaying 135851-135860 of 1611142 results.
ID: 135851
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135852
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 135853
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135854
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135855
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135856
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135857
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135858
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 135859
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135860
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0