CMS Formulary

Displaying 135961-135970 of 1611142 results.
ID: 135961
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135962
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 135963
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 135964
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135965
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 135966
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135967
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135968
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135969
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135970
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0