CMS Formulary

Displaying 138281-138290 of 1611142 results.
ID: 138281
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138282
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138283
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138284
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138285
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138286
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138287
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138288
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138289
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138290
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0