CMS Formulary

Displaying 136371-136380 of 1611142 results.
ID: 136371
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2380256
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136372
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847252
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136373
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311026
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136374
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1435117
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 136375
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 351859
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136376
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 106892
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136377
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847254
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136378
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847213
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136379
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652640
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136380
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847189
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0