CMS Formulary

Displaying 137551-137560 of 1611142 results.
ID: 137551
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137552
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137553
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137554
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1293639
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137555
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137556
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137557
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137558
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137559
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137560
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0