CMS Formulary

Displaying 135971-135980 of 1611142 results.
ID: 135971
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135972
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135973
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135974
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135975
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135976
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135977
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135978
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 135979
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135980
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0