CMS Formulary

Displaying 131561-131570 of 1611142 results.
ID: 131561
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131562
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131563
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131564
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731235
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131565
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731241
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131566
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131567
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131568
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 352262
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131569
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131570
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0