CMS Formulary

Displaying 137511-137520 of 1611142 results.
ID: 137511
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 137512
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137513
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 137514
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137515
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137516
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137517
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137518
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137519
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137520
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30