CMS Formulary

Displaying 131211-131220 of 1611142 results.
ID: 131211
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131212
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131213
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131214
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131215
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131216
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131217
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131218
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131219
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131220
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0