CMS Formulary

Displaying 139641-139650 of 1611142 results.
ID: 139641
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139642
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139643
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139644
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139645
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139646
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139647
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139648
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139649
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139650
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30