CMS Formulary

Displaying 137581-137590 of 1611142 results.
ID: 137581
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 137582
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137583
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137584
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137585
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137586
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137587
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137588
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137589
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137590
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197411
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0