CMS Formulary

Displaying 130251-130260 of 1611142 results.
ID: 130251
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130252
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130253
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130254
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130255
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130256
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130257
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130258
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130259
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130260
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0