CMS Formulary

Displaying 138521-138530 of 1611142 results.
ID: 138521
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138522
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138523
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138524
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138525
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138526
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138527
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138528
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138529
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138530
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0