CMS Formulary

Displaying 136431-136440 of 1611142 results.
ID: 136431
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136432
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136433
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136434
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 136435
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 136436
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 136437
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136438
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 136439
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136440
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0