CMS Formulary

Displaying 139721-139730 of 1611142 results.
ID: 139721
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311877
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139722
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139723
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139724
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866905
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139725
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139726
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139727
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139728
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139729
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139730
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0