CMS Formulary

Displaying 132921-132930 of 1611142 results.
ID: 132921
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132922
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132923
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206792
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132924
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132925
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132926
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 208821
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132927
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132928
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132929
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213320
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132930
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 351875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0