CMS Formulary

Displaying 137541-137550 of 1611142 results.
ID: 137541
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137542
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137543
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137544
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137545
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137546
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1993222
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137547
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 430551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137548
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137549
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137550
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0