CMS Formulary

Displaying 130741-130750 of 1611142 results.
ID: 130741
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130742
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130743
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130744
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130745
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130746
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130747
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130748
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130749
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130750
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0