CMS Formulary

Displaying 136601-136610 of 1611142 results.
ID: 136601
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136602
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136603
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136604
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136605
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136606
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136607
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136608
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136609
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136610
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30