CMS Formulary

Displaying 137211-137220 of 1611142 results.
ID: 137211
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137212
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137213
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137214
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137215
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137216
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137217
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1918042
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137218
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111641
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137219
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1487361
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 137220
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 351137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0