CMS Formulary

Displaying 129641-129650 of 1611142 results.
ID: 129641
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 848330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129642
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129643
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129644
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129645
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129646
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129647
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129648
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129649
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129650
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0