CMS Formulary

Displaying 137121-137130 of 1611142 results.
ID: 137121
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1860239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137122
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137123
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 615107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137124
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 615111
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137125
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847626
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137126
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312128
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137127
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 240637
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137128
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 801405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137129
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137130
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30