CMS Formulary

Displaying 139971-139980 of 1611142 results.
ID: 139971
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139972
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 525
Qty Limit Days: 30
ID: 139973
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139974
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284516
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139975
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284514
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139976
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139977
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139978
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 349590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139979
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139980
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 242754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0