CMS Formulary

Displaying 139881-139890 of 1611142 results.
ID: 139881
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139882
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139883
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139884
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139885
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139886
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139887
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139888
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139889
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139890
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0