CMS Formulary

Displaying 137571-137580 of 1611142 results.
ID: 137571
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 899461
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137572
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 899485
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137573
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1101926
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137574
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 899495
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137575
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1101932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137576
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199119
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137577
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1793916
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 137578
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1657173
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 137579
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1657160
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 137580
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30