CMS Formulary

Displaying 136551-136560 of 1611142 results.
ID: 136551
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136552
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136553
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136554
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136555
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136556
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136557
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 136558
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3600
Qty Limit Days: 30
ID: 136559
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 136560
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 205301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0