CMS Formulary

Displaying 139631-139640 of 1611142 results.
ID: 139631
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139632
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139633
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139634
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139635
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139636
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139637
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 139638
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139639
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139640
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0