CMS Formulary

Displaying 136041-136050 of 1611142 results.
ID: 136041
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136042
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136043
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136044
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136045
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136046
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136047
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136048
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136049
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136050
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0