CMS Formulary

Displaying 139231-139240 of 1611142 results.
ID: 139231
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139232
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139233
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139234
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139235
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139236
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139237
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139238
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139239
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139240
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0