CMS Formulary

Displaying 137631-137640 of 1611142 results.
ID: 137631
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855342
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137632
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855348
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137633
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855300
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137634
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809730
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137635
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809738
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137636
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809667
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137637
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1233711
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137638
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1013867
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137639
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854228
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 137640
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30