CMS Formulary

Displaying 139901-139910 of 1611142 results.
ID: 139901
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 139902
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139903
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139904
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 139905
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 139906
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 139907
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139908
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1249631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139909
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 139910
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30