CMS Formulary

Displaying 136731-136740 of 1611142 results.
ID: 136731
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1365866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136732
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1656351
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136733
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136734
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136735
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136736
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136737
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 136738
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136739
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 136740
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28