CMS Formulary

Displaying 139201-139210 of 1611142 results.
ID: 139201
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139202
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139203
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139204
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139205
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139206
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 204509
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139207
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312069
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139208
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139209
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1722919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139210
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1722921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0