CMS Formulary

Displaying 132911-132920 of 1611142 results.
ID: 132911
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132912
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132913
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132914
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132915
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132916
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132917
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132918
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132919
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132920
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0