CMS Formulary

Displaying 129841-129850 of 1611142 results.
ID: 129841
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115459
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129842
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129843
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129844
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946522
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129845
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966271
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129846
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129847
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129848
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129849
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129850
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 966158
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0