CMS Formulary

Displaying 138091-138100 of 1611142 results.
ID: 138091
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138092
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138093
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138094
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138095
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138096
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138097
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138098
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138099
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138100
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30