CMS Formulary

Displaying 138271-138280 of 1611142 results.
ID: 138271
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138272
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138273
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138274
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138275
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138276
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138277
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138278
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138279
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138280
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0