CMS Formulary

Displaying 132801-132810 of 1611142 results.
ID: 132801
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132802
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132803
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132804
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132805
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 260285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132806
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 205826
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132807
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132808
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856935
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132809
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132810
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000089
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0