CMS Formulary

Displaying 132831-132840 of 1611142 results.
ID: 132831
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132832
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132833
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132834
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132835
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132836
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132837
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132838
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 706467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132839
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905164
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132840
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0