CMS Formulary

Displaying 130581-130590 of 1611142 results.
ID: 130581
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130582
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130583
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130584
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130585
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130586
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130587
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130588
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130589
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1993222
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130590
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 430551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0