CMS Formulary

Displaying 130361-130370 of 1611142 results.
ID: 130361
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130362
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130363
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130364
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659292
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130365
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659294
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130366
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 206423
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130367
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 801451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130368
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1668267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130369
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130370
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0