CMS Formulary

Displaying 137131-137140 of 1611142 results.
ID: 137131
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137132
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137133
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137134
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137135
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 137136
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137137
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137138
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137139
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137140
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0