CMS Formulary

Displaying 137401-137410 of 1611142 results.
ID: 137401
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137402
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137403
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137404
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137405
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137406
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137407
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137408
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137409
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137410
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0