CMS Formulary

Displaying 136501-136510 of 1611142 results.
ID: 136501
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136502
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136503
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136504
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136505
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136506
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136507
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136508
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136509
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136510
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30