CMS Formulary

Displaying 135881-135890 of 1611142 results.
ID: 135881
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135882
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 135883
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135884
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135885
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135886
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135887
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135888
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135889
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135890
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0