CMS Formulary

Displaying 131741-131750 of 1611142 results.
ID: 131741
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131742
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131743
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131744
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131745
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131746
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131747
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131748
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131749
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131750
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0