CMS Formulary

Displaying 136021-136030 of 1611142 results.
ID: 136021
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136022
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136023
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136024
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136025
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136026
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136027
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136028
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136029
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136030
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0