CMS Formulary

Displaying 131-140 of 1611142 results.
ID: 131
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2375329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 132
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2099302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 133
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003757
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 2003767
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 136
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 137
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 138
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 139
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 140
Formulary ID: 00021000
Formulary Version: 14
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0