CMS Formulary

Displaying 138531-138540 of 1611142 results.
ID: 138531
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 749148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138532
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138533
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138534
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138535
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138536
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138537
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138538
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138539
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138540
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0