CMS Formulary

Displaying 136071-136080 of 1611142 results.
ID: 136071
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136072
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136073
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136074
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136075
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136076
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136077
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136078
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136079
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136080
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30