CMS Formulary

Displaying 131411-131420 of 1611142 results.
ID: 131411
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131412
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131413
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131414
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131415
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131416
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131417
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131418
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131419
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131420
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0