CMS Formulary

Displaying 139591-139600 of 1611142 results.
ID: 139591
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139592
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139593
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139594
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139595
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139596
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139597
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139598
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139599
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139600
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0