CMS Formulary

Displaying 137881-137890 of 1611142 results.
ID: 137881
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137882
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137883
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137884
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137885
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137886
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 754512
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137887
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 137888
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137889
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863603
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137890
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0