CMS Formulary

Displaying 137411-137420 of 1611142 results.
ID: 137411
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137412
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137413
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137414
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137415
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137416
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137417
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137418
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 753482
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137419
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 750268
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137420
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0