CMS Formulary

Displaying 138031-138040 of 1611142 results.
ID: 138031
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138032
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138033
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138034
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138035
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138036
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138037
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138038
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138039
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138040
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0