CMS Formulary

Displaying 136271-136280 of 1611142 results.
ID: 136271
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 136272
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 136273
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 136274
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 136275
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 136276
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 136277
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 136278
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 136279
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 136280
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30