CMS Formulary

Displaying 133901-133910 of 1611142 results.
ID: 133901
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133902
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133903
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133904
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133905
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133906
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133907
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133908
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133909
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133910
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0