CMS Formulary

Displaying 137081-137090 of 1611142 results.
ID: 137081
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137082
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137083
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137084
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137085
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137086
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137087
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137088
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 137089
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 847913
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 137090
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28