CMS Formulary

Displaying 136031-136040 of 1611142 results.
ID: 136031
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136032
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136033
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136034
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136035
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136036
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136037
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136038
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136039
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136040
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0