CMS Formulary

Displaying 137521-137530 of 1611142 results.
ID: 137521
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137522
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137523
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137524
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137525
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359285
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137526
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137527
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359353
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137528
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359358
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137529
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137530
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0