CMS Formulary

Displaying 137161-137170 of 1611142 results.
ID: 137161
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137162
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137163
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137164
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137165
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137166
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137167
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 876524
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137168
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 876514
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137169
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 876529
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137170
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 876519
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30