CMS Formulary

Displaying 138511-138520 of 1611142 results.
ID: 138511
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138512
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138513
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138514
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138515
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138516
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138517
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138518
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138519
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138520
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0