CMS Formulary

Displaying 130201-130210 of 1611142 results.
ID: 130201
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130202
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130203
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130204
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130205
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130206
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130207
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1794886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130208
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795346
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130209
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130210
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801112
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0