CMS Formulary

Displaying 137201-137210 of 1611142 results.
ID: 137201
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137202
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137203
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137204
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830865
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137205
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830869
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137206
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830872
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137207
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137208
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137209
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137210
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30