CMS Formulary

Displaying 137321-137330 of 1611142 results.
ID: 137321
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137322
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137323
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137324
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137325
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137326
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137327
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137328
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137329
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137330
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30