CMS Formulary

Displaying 138981-138990 of 1611142 results.
ID: 138981
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138982
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138983
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138984
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138985
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138986
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138987
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138988
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138989
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138990
Formulary ID: 00021057
Formulary Version: 16
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0