CMS Formulary

Displaying 136881-136890 of 1611142 results.
ID: 136881
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136882
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136883
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136884
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136885
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136886
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136887
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136888
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136889
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136890
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30