CMS Formulary

Displaying 138321-138330 of 1611142 results.
ID: 138321
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138322
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138323
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138324
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2106997
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138325
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1660690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138326
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2397128
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138327
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 314106
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138328
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138329
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138330
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0