CMS Formulary

Displaying 138551-138560 of 1611142 results.
ID: 138551
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138552
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138553
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138554
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138555
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138556
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 138557
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138558
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138559
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138560
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0