CMS Formulary

Displaying 136921-136930 of 1611142 results.
ID: 136921
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136922
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136923
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136924
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1550940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 136925
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136926
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136927
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136928
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136929
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136930
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0