CMS Formulary

Displaying 130411-130420 of 1611142 results.
ID: 130411
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130412
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130413
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130414
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130415
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130416
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130417
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130418
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130419
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130420
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0