CMS Formulary

Displaying 130001-130010 of 1611142 results.
ID: 130001
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 899439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130002
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130003
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130004
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130005
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 241834
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130006
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876397
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130007
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1235267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130008
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130009
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130010
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0