CMS Formulary

Displaying 139461-139470 of 1611142 results.
ID: 139461
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139462
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896228
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139463
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139464
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139465
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139466
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139467
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139468
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139469
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139470
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30