CMS Formulary

Displaying 136771-136780 of 1611142 results.
ID: 136771
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136772
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198107
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136773
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 136774
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136775
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136776
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136777
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136778
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198047
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136779
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312059
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136780
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0