CMS Formulary

Displaying 130591-130600 of 1611142 results.
ID: 130591
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130592
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130593
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130594
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312071
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130595
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859867
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130596
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198159
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130597
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1293639
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130598
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191256
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130599
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130600
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0