CMS Formulary

Displaying 131471-131480 of 1611142 results.
ID: 131471
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131472
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131473
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131474
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131475
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131476
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131477
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 430902
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131478
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131479
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131480
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0