CMS Formulary

Displaying 138581-138590 of 1611142 results.
ID: 138581
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138582
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 430902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138583
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138584
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138585
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138586
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138587
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716215
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138588
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716219
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138589
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716223
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138590
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0