CMS Formulary

Displaying 133141-133150 of 1611142 results.
ID: 133141
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133142
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133143
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133144
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133145
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133146
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133147
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133148
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133149
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133150
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0