CMS Formulary

Displaying 136141-136150 of 1611142 results.
ID: 136141
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136142
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136143
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1731020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136144
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136145
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1944656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136146
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136147
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136148
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136149
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136150
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30