CMS Formulary

Displaying 139321-139330 of 1611142 results.
ID: 139321
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139322
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139323
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139324
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139325
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139326
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139327
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139328
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139329
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139330
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0