CMS Formulary

Displaying 130771-130780 of 1611142 results.
ID: 130771
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855664
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130772
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 995281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130773
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130774
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1304988
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130775
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1661092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130776
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130777
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130778
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130779
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130780
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0