CMS Formulary

Displaying 138651-138660 of 1611142 results.
ID: 138651
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138652
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138653
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138654
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138655
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 207949
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138656
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966154
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138657
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966161
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138658
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966167
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138659
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138660
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 966178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0