CMS Formulary

Displaying 129741-129750 of 1611142 results.
ID: 129741
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129742
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129743
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129744
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129745
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129746
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129747
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129748
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129749
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129750
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0