CMS Formulary

Displaying 139711-139720 of 1611142 results.
ID: 139711
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139712
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139713
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139714
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139715
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139716
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139717
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139718
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139719
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139720
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0