CMS Formulary

Displaying 137251-137260 of 1611142 results.
ID: 137251
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2110516
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137252
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 137253
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137254
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137255
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137256
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137257
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 137258
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137259
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 137260
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30