CMS Formulary

Displaying 138561-138570 of 1611142 results.
ID: 138561
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138562
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138563
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138564
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138565
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138566
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138567
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138568
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138569
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138570
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0