CMS Formulary

Displaying 136901-136910 of 1611142 results.
ID: 136901
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136902
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136903
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136904
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136905
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136906
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136907
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136908
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136909
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5400
Qty Limit Days: 30
ID: 136910
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0