CMS Formulary

Displaying 136711-136720 of 1611142 results.
ID: 136711
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1656346
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136712
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1425110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136713
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1425118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136714
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 867506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136715
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 672152
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136716
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1425230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136717
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1425228
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136718
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136719
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136720
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30