CMS Formulary

Displaying 136241-136250 of 1611142 results.
ID: 136241
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 136242
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 136243
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136244
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136245
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 136246
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 136247
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 136248
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136249
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1249631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136250
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30