CMS Formulary

Displaying 136191-136200 of 1611142 results.
ID: 136191
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136192
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136193
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809416
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136194
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136195
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136196
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136197
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 136198
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 136199
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136200
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0