CMS Formulary

Displaying 138591-138600 of 1611142 results.
ID: 138591
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138592
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138593
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138594
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138595
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138596
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138597
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138598
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998689
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138599
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 998685
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138600
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 206791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30