CMS Formulary

Displaying 136441-136450 of 1611142 results.
ID: 136441
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136442
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 206417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136443
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136444
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136445
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136446
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136447
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136448
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136449
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136450
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0