CMS Formulary

Displaying 131371-131380 of 1611142 results.
ID: 131371
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131372
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131373
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131374
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131375
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131376
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131377
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131378
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131379
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131380
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0