CMS Formulary

Displaying 137621-137630 of 1611142 results.
ID: 137621
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137622
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137623
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137624
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137625
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137626
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855306
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137627
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855316
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137628
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855322
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137629
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855328
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137630
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 855336
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0