CMS Formulary

Displaying 133681-133690 of 1611142 results.
ID: 133681
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133682
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133683
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133684
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133685
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133686
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133687
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133688
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133689
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133690
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0