CMS Formulary

Displaying 130861-130870 of 1611142 results.
ID: 130861
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099288
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130862
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099300
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130863
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130864
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130865
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130866
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130867
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197433
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130868
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130869
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130870
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0