CMS Formulary

Displaying 136121-136130 of 1611142 results.
ID: 136121
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136122
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136123
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136124
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 136125
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 136126
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136127
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136128
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136129
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136130
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0