CMS Formulary

Displaying 137531-137540 of 1611142 results.
ID: 137531
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137532
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137533
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137534
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137535
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137536
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137537
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137538
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137539
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137540
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0