CMS Formulary

Displaying 136691-136700 of 1611142 results.
ID: 136691
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136692
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136693
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136694
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136695
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136696
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136697
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136698
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 136699
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136700
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0