CMS Formulary

Displaying 138571-138580 of 1611142 results.
ID: 138571
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138572
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138573
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 152
Qty Limit Days: 30
ID: 138574
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138575
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138576
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138577
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138578
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138579
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138580
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0