CMS Formulary

Displaying 131841-131850 of 1611142 results.
ID: 131841
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131842
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131843
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131844
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131845
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131846
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131847
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131848
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131849
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131850
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0