CMS Formulary

Displaying 139611-139620 of 1611142 results.
ID: 139611
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139612
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139613
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139614
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1727521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139615
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139616
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139617
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 139618
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139619
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139620
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30