CMS Formulary

Displaying 138181-138190 of 1611142 results.
ID: 138181
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138182
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138183
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138184
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138185
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138186
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138187
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138188
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138189
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138190
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0