CMS Formulary

Displaying 129961-129970 of 1611142 results.
ID: 129961
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129962
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129963
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129964
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129965
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129966
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129967
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129968
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129969
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129970
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0