CMS Formulary

Displaying 139571-139580 of 1611142 results.
ID: 139571
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139572
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139573
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199351
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139574
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139575
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139576
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139577
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139578
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139579
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139580
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0