CMS Formulary

Displaying 138311-138320 of 1611142 results.
ID: 138311
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138312
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138313
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1653217
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138314
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138315
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111018
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138316
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 212381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138317
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138318
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138319
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138320
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0