CMS Formulary

Displaying 131801-131810 of 1611142 results.
ID: 131801
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131802
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131803
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966164
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131804
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131805
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966175
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131806
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131807
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966184
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131808
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131809
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966194
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131810
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966200
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0