CMS Formulary

Displaying 136421-136430 of 1611142 results.
ID: 136421
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136422
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1924315
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136423
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486841
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136424
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 136425
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 136426
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136427
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 136428
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 136429
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 136430
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1