CMS Formulary

Displaying 137061-137070 of 1611142 results.
ID: 137061
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1189640
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137062
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 800933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137063
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 207273
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137064
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437709
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137065
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137066
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137067
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137068
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137069
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 137070
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30