CMS Formulary

Displaying 138151-138160 of 1611142 results.
ID: 138151
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138152
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138153
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138154
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138155
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138156
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138157
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138158
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 138159
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138160
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0