CMS Formulary

Displaying 138611-138620 of 1611142 results.
ID: 138611
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138612
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138613
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138614
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138615
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138616
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138617
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138618
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138619
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 138620
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0