CMS Formulary

Displaying 130321-130330 of 1611142 results.
ID: 130321
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130322
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 209789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130323
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 209788
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130324
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130325
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130326
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130327
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130328
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 130329
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 130330
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0