CMS Formulary

Displaying 136951-136960 of 1611142 results.
ID: 136951
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136952
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 136953
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136954
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136955
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136956
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136957
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136958
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 153095
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136959
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136960
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30