CMS Formulary

Displaying 136091-136100 of 1611142 results.
ID: 136091
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 136092
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 136093
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 136094
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136095
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136096
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136097
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830897
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136098
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136099
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200220
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 136100
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0