CMS Formulary

Displaying 136801-136810 of 1611142 results.
ID: 136801
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136802
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136803
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136804
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136805
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136806
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136807
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136808
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136809
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136810
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0