CMS Formulary

Displaying 130471-130480 of 1611142 results.
ID: 130471
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751871
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130472
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130473
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130474
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130475
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130476
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130477
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130478
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130479
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130480
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0