CMS Formulary

Displaying 130111-130120 of 1611142 results.
ID: 130111
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 249066
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130112
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130113
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130114
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130115
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 898372
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130116
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130117
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130118
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130119
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130120
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0