CMS Formulary

Displaying 136761-136770 of 1611142 results.
ID: 136761
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136762
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136763
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136764
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136765
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831103
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136766
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136767
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136768
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136769
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136770
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0