CMS Formulary

Displaying 136681-136690 of 1611142 results.
ID: 136681
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136682
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966171
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136683
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136684
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966250
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136685
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136686
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136687
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136688
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136689
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966251
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136690
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0