CMS Formulary

Displaying 130371-130380 of 1611142 results.
ID: 130371
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130372
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130373
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130374
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130375
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130376
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130377
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130378
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130379
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130380
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30