CMS Formulary

Displaying 137901-137910 of 1611142 results.
ID: 137901
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149376
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137902
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137903
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137904
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137905
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137906
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137907
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 201388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137908
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137909
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137910
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0