CMS Formulary

Displaying 130821-130830 of 1611142 results.
ID: 130821
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130822
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130823
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130824
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130825
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130826
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130827
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130828
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 130829
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130830
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0