CMS Formulary

Displaying 131901-131910 of 1611142 results.
ID: 131901
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831300
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131902
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131903
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831349
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131904
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801298
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131905
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131906
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131907
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131908
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131909
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131910
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0