CMS Formulary

Displaying 138231-138240 of 1611142 results.
ID: 138231
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138232
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138233
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138234
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 138235
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138236
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138237
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138238
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138239
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 138240
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1