CMS Formulary

Displaying 137951-137960 of 1611142 results.
ID: 137951
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137952
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137953
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137954
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137955
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137956
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137957
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137958
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137959
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137960
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0