CMS Formulary

Displaying 139271-139280 of 1611142 results.
ID: 139271
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1600776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139272
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1600915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139273
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1600917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139274
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139275
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139276
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 730834
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139277
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139278
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139279
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139280
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0