CMS Formulary

Displaying 139681-139690 of 1611142 results.
ID: 139681
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139682
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139683
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139684
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139685
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139686
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139687
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139688
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139689
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139690
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0