CMS Formulary

Displaying 137711-137720 of 1611142 results.
ID: 137711
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137712
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 137713
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137714
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137715
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137716
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137717
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137718
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137719
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137720
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0