CMS Formulary

Displaying 137841-137850 of 1611142 results.
ID: 137841
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137842
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137843
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 137844
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137845
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 137846
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 137847
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137848
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137849
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649429
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137850
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650142
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0