CMS Formulary

Displaying 130871-130880 of 1611142 results.
ID: 130871
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130872
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130873
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130874
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130875
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130876
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130877
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130878
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130879
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130880
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0