CMS Formulary

Displaying 137291-137300 of 1611142 results.
ID: 137291
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1668267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137292
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137293
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137294
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137295
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137296
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137297
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137298
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137299
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137300
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0