CMS Formulary

Displaying 132701-132710 of 1611142 results.
ID: 132701
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 865098
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132702
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132703
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132704
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132705
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132706
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132707
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132708
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132709
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132710
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0