CMS Formulary

Displaying 138751-138760 of 1611142 results.
ID: 138751
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138752
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138753
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138754
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539248
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138755
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138756
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138757
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138758
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138759
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 803371
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138760
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300810
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1