CMS Formulary

Displaying 137861-137870 of 1611142 results.
ID: 137861
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137862
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137863
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 213263
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137864
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137865
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137866
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137867
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137868
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137869
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137870
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1312627
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0