CMS Formulary

Displaying 130421-130430 of 1611142 results.
ID: 130421
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130422
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130423
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130424
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130425
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 130426
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 130427
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130428
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130429
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130430
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859841
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0