CMS Formulary

Displaying 136491-136500 of 1611142 results.
ID: 136491
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136492
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136493
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136494
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136495
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136496
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 207370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136497
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136498
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136499
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136500
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 205739
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0