CMS Formulary

Displaying 138921-138930 of 1611142 results.
ID: 138921
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138922
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138923
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138924
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138925
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138926
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138927
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138928
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138929
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138930
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0