CMS Formulary

Displaying 137671-137680 of 1611142 results.
ID: 137671
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137672
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137673
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137674
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 801054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137675
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137676
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137677
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137678
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137679
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137680
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30