CMS Formulary

Displaying 137911-137920 of 1611142 results.
ID: 137911
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137912
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137913
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137914
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137915
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137916
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137917
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137918
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137919
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137920
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0