CMS Formulary

Displaying 131951-131960 of 1611142 results.
ID: 131951
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131952
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131953
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131954
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131955
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131956
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131957
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131958
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131959
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131960
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099678
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0