CMS Formulary

Displaying 133881-133890 of 1611142 results.
ID: 133881
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133882
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133883
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133884
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133885
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133886
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133887
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1993222
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133888
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 430551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133889
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133890
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0