CMS Formulary

Displaying 130311-130320 of 1611142 results.
ID: 130311
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130312
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130313
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130314
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130315
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130316
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130317
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130318
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130319
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130320
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30