CMS Formulary

Displaying 137831-137840 of 1611142 results.
ID: 137831
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137832
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137833
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137834
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137835
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137836
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137837
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137838
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 137839
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 137840
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0