CMS Formulary

Displaying 136631-136640 of 1611142 results.
ID: 136631
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136632
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136633
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136634
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136635
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136636
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136637
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136638
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136639
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136640
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30