CMS Formulary

Displaying 137931-137940 of 1611142 results.
ID: 137931
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137932
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137933
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137934
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137935
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137936
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137937
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313762
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137938
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313761
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137939
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137940
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0