CMS Formulary

Displaying 138761-138770 of 1611142 results.
ID: 138761
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798430
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138762
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138763
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1986830
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138764
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798482
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 138765
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798479
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 138766
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138767
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138768
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138769
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138770
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1