CMS Formulary

Displaying 136211-136220 of 1611142 results.
ID: 136211
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 797061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136212
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 797065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136213
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 136214
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136215
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136216
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136217
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136218
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136219
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136220
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0