CMS Formulary

Displaying 131421-131430 of 1611142 results.
ID: 131421
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131422
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131423
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131424
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131425
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131426
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131427
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131428
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131429
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131430
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0