CMS Formulary

Displaying 131761-131770 of 1611142 results.
ID: 131761
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131762
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131763
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131764
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131765
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131766
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131767
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131768
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308739
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131769
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131770
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0