CMS Formulary

Displaying 138791-138800 of 1611142 results.
ID: 138791
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138792
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138793
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138794
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138795
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138796
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138797
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138798
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138799
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138800
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30