CMS Formulary

Displaying 137761-137770 of 1611142 results.
ID: 137761
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137762
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137763
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137764
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137765
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137766
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137767
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137768
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137769
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137770
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0