CMS Formulary

Displaying 139871-139880 of 1611142 results.
ID: 139871
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 797065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139872
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921081
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 139873
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1866047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139874
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099026
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139875
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099269
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139876
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1006065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139877
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1020155
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139878
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139879
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139880
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0