CMS Formulary

Displaying 129981-129990 of 1611142 results.
ID: 129981
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129982
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129983
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129984
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129985
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129986
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129987
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129988
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129989
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129990
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0