CMS Formulary

Displaying 139001-139010 of 1611142 results.
ID: 139001
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966211
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139002
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966228
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139003
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966244
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139004
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139005
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139006
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966233
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139007
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966235
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139008
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966237
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139009
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966238
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139010
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966246
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0