CMS Formulary

Displaying 139891-139900 of 1611142 results.
ID: 139891
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139892
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139893
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139894
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139895
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139896
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1599841
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139897
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139898
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139899
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 139900
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28