CMS Formulary

Displaying 136311-136320 of 1611142 results.
ID: 136311
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136312
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136313
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 525
Qty Limit Days: 30
ID: 136314
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136315
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284516
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136316
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284514
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136317
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136318
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136319
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 349590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136320
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0