CMS Formulary

Displaying 137311-137320 of 1611142 results.
ID: 137311
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137312
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137313
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 137314
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137315
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137316
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137317
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137318
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137319
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137320
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0