CMS Formulary

Displaying 136101-136110 of 1611142 results.
ID: 136101
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136102
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136103
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136104
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 136105
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136106
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136107
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136108
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136109
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136110
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265729
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30