CMS Formulary

Displaying 137891-137900 of 1611142 results.
ID: 137891
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137892
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137893
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137894
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137895
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137896
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137897
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 137898
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 137899
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137900
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30