CMS Formulary

Displaying 137151-137160 of 1611142 results.
ID: 137151
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 866491
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137152
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137153
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197508
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137154
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137155
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137156
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137157
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137158
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137159
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137160
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0