CMS Formulary

Displaying 136051-136060 of 1611142 results.
ID: 136051
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136052
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136053
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136054
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136055
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136056
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136057
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136058
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136059
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136060
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30