CMS Formulary

Displaying 136831-136840 of 1611142 results.
ID: 136831
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136832
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136833
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136834
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136835
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136836
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136837
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136838
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136839
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136840
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30