CMS Formulary

Displaying 136331-136340 of 1611142 results.
ID: 136331
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136332
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136333
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136334
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136335
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136336
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136337
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 208560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136338
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136339
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136340
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0