CMS Formulary

Displaying 139241-139250 of 1611142 results.
ID: 139241
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1442681
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139242
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1442683
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139243
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2101459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139244
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2101465
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139245
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 867381
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139246
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1926823
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139247
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1926827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139248
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809513
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139249
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139250
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0