CMS Formulary

Displaying 129941-129950 of 1611142 results.
ID: 129941
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866018
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129942
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 603103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129943
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 106346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 110
Qty Limit Days: 30
ID: 129944
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098649
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129945
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098670
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129946
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098674
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129947
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129948
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923426
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129949
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129950
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 904589
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0