CMS Formulary

Displaying 138391-138400 of 1611142 results.
ID: 138391
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138392
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138393
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138394
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706829
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138395
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 706825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138396
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 858074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138397
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 858051
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138398
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 858057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138399
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 858055
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138400
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 858053
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0