CMS Formulary

Displaying 131851-131860 of 1611142 results.
ID: 131851
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131852
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131853
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131854
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131855
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131856
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131857
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131858
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131859
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131860
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0