CMS Formulary

Displaying 139851-139860 of 1611142 results.
ID: 139851
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139852
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809416
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139853
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139854
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139855
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139856
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197943
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 139857
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197944
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 139858
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139859
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139860
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0