CMS Formulary

Displaying 130141-130150 of 1611142 results.
ID: 130141
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130142
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130143
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130144
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130145
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1867547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130146
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 130147
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 608934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130148
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130149
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130150
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0