CMS Formulary

Displaying 137141-137150 of 1611142 results.
ID: 137141
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137142
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137143
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137144
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137145
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137146
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137147
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137148
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310670
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137149
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373483
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137150
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373491
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30