CMS Formulary

Displaying 136361-136370 of 1611142 results.
ID: 136361
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136362
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136363
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136364
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136365
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136366
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136367
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136368
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1926331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136369
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136370
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311036
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0