CMS Formulary

Displaying 129951-129960 of 1611142 results.
ID: 129951
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 894859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129952
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866042
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129953
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129954
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855302
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129955
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855312
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129956
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855318
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129957
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129958
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855338
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129959
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129960
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0