CMS Formulary

Displaying 133741-133750 of 1611142 results.
ID: 133741
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133742
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133743
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 643488
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133744
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404065
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133745
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133746
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133747
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133748
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 762007
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133749
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133750
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0