CMS Formulary

Displaying 137391-137400 of 1611142 results.
ID: 137391
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137392
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137393
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137394
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137395
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137396
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137397
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137398
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137399
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137400
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0