CMS Formulary

Displaying 139081-139090 of 1611142 results.
ID: 139081
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139082
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139083
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139084
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139085
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139086
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139087
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139088
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139089
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139090
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0