CMS Formulary

Displaying 137791-137800 of 1611142 results.
ID: 137791
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137792
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137793
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137794
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137795
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137796
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137797
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137798
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137799
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 137800
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30