CMS Formulary

Displaying 136911-136920 of 1611142 results.
ID: 136911
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136912
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136913
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136914
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136915
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 136916
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136917
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 136918
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 136919
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136920
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0