CMS Formulary

Displaying 136981-136990 of 1611142 results.
ID: 136981
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 895996
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 136982
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896001
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 136983
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896006
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 136984
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136985
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1487528
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 136986
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539885
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136987
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1547660
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136988
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1547672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136989
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1720606
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 136990
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1648789
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30