CMS Formulary

Displaying 136931-136940 of 1611142 results.
ID: 136931
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136932
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136933
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136934
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136935
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136936
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136937
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136938
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136939
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136940
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0