CMS Formulary

Displaying 139671-139680 of 1611142 results.
ID: 139671
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139672
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139673
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139674
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139675
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 139676
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 139677
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 139678
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 139679
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139680
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0