CMS Formulary

Displaying 136941-136950 of 1611142 results.
ID: 136941
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136942
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136943
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136944
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136945
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136946
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1670023
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136947
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1670016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136948
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2107522
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136949
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 616238
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136950
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30