CMS Formulary

Displaying 138781-138790 of 1611142 results.
ID: 138781
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138782
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138783
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138784
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138785
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138786
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138787
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138788
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138789
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138790
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0