CMS Formulary

Displaying 137661-137670 of 1611142 results.
ID: 137661
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137662
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137663
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137664
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137665
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137666
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137667
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946527
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137668
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946525
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137669
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137670
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30