CMS Formulary

Displaying 137741-137750 of 1611142 results.
ID: 137741
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137742
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137743
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137744
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137745
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137746
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137747
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137748
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137749
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 137750
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0