CMS Formulary

Displaying 139041-139050 of 1611142 results.
ID: 139041
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139042
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139043
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139044
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139045
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139046
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139047
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139048
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139049
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139050
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0