CMS Formulary

Displaying 139561-139570 of 1611142 results.
ID: 139561
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139562
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139563
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139564
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139565
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139566
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139567
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139568
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 139569
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139570
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30