CMS Formulary

Displaying 137231-137240 of 1611142 results.
ID: 137231
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137232
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137233
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1095224
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137234
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137235
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137236
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137237
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137238
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310404
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137239
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137240
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30