CMS Formulary

Displaying 137031-137040 of 1611142 results.
ID: 137031
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137032
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1867547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137033
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 137034
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 608934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137035
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137036
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137037
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137038
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137039
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137040
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0