CMS Formulary

Displaying 136111-136120 of 1611142 results.
ID: 136111
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136112
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2265735
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136113
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 877417
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136114
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809643
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136115
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809499
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136116
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136117
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664440
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136118
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136119
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136120
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0