CMS Formulary

Displaying 136531-136540 of 1611142 results.
ID: 136531
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136532
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136533
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136534
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136535
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136536
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136537
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136538
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 136539
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 3900
Qty Limit Days: 30
ID: 136540
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30