CMS Formulary

Displaying 131931-131940 of 1611142 results.
ID: 131931
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131932
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131933
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131934
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131935
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131936
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131937
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131938
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131939
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131940
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0