CMS Formulary

Displaying 137461-137470 of 1611142 results.
ID: 137461
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137462
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137463
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137464
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137465
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137466
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137467
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137468
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137469
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137470
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30