CMS Formulary

Displaying 130031-130040 of 1611142 results.
ID: 130031
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130032
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130033
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130034
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130035
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130036
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130037
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130038
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130039
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 130040
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30