CMS Formulary

Displaying 139091-139100 of 1611142 results.
ID: 139091
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139092
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139093
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139094
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139095
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139096
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139097
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139098
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139099
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139100
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 854868
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0