CMS Formulary

Displaying 130071-130080 of 1611142 results.
ID: 130071
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130072
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130073
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130074
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130075
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130076
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130077
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130078
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130079
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130080
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0