CMS Formulary

Displaying 139861-139870 of 1611142 results.
ID: 139861
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139862
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139863
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139864
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1855072
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139865
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1986331
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139866
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1918230
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139867
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054269
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 139868
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 432400
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 139869
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1940654
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 139870
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 797061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0