CMS Formulary

Displaying 135921-135930 of 1611142 results.
ID: 135921
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135922
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135923
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135924
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135925
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135926
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833709
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135927
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833711
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135928
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833713
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135929
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135930
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0