CMS Formulary

Displaying 136341-136350 of 1611142 results.
ID: 136341
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136342
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136343
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136344
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 967021
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136345
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1248442
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136346
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1551300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 136347
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1551306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 136348
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058877
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 136349
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2395779
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 136350
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058887
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30