CMS Formulary

Displaying 139031-139040 of 1611142 results.
ID: 139031
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139032
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139033
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139034
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139035
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139036
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139037
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139038
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139039
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139040
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0