CMS Formulary

Displaying 137981-137990 of 1611142 results.
ID: 137981
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137982
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137983
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137984
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 137985
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137986
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137987
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 137988
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137989
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 137990
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30