CMS Formulary

Displaying 136221-136230 of 1611142 results.
ID: 136221
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136222
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136223
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136224
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136225
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136226
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136227
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136228
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136229
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136230
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0