CMS Formulary

Displaying 135931-135940 of 1611142 results.
ID: 135931
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135932
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135933
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135934
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135935
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135936
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135937
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 135938
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135939
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135940
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0