CMS Formulary

Displaying 137501-137510 of 1611142 results.
ID: 137501
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137502
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137503
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137504
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137505
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137506
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137507
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137508
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137509
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137510
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30