CMS Formulary

Displaying 136661-136670 of 1611142 results.
ID: 136661
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1488617
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136662
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136663
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 136664
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136665
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1940709
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 84
Qty Limit Days: 28
ID: 136666
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835896
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136667
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835835
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136668
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1115468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136669
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1926069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 136670
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1115259
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0