CMS Formulary

Displaying 137111-137120 of 1611142 results.
ID: 137111
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 801648
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137112
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1863973
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137113
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137114
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137115
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137116
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 615100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137117
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137118
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 637551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137119
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 237367
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137120
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1860463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0