CMS Formulary

Displaying 130801-130810 of 1611142 results.
ID: 130801
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130802
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130803
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130804
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130805
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130806
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130807
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130808
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130809
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130810
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0