CMS Formulary

Displaying 136471-136480 of 1611142 results.
ID: 136471
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190957
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136472
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136473
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136474
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136475
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136476
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136477
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136478
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 153579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136479
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 153580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136480
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897294
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0