CMS Formulary

Displaying 136291-136300 of 1611142 results.
ID: 136291
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136292
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136293
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136294
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136295
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136296
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136297
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136298
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136299
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 136300
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28