CMS Formulary

Displaying 138911-138920 of 1611142 results.
ID: 138911
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1596023
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138912
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138913
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138914
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138915
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138916
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138917
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138918
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138919
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138920
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0