CMS Formulary

Displaying 130041-130050 of 1611142 results.
ID: 130041
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130042
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130043
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130044
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130045
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130046
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130047
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834127
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130048
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 141935
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130049
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 849385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130050
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861848
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0