CMS Formulary

Displaying 138991-139000 of 1611142 results.
ID: 138991
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138992
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966164
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138993
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138994
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966175
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138995
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138996
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966184
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138997
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138998
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966194
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138999
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966200
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139000
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966204
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0