CMS Formulary

Displaying 136261-136270 of 1611142 results.
ID: 136261
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136262
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099323
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136263
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136264
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136265
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136266
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136267
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136268
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136269
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136270
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28