CMS Formulary

Displaying 131431-131440 of 1611142 results.
ID: 131431
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131432
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131433
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131434
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131435
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131436
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131437
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131438
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131439
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131440
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0