CMS Formulary

Displaying 130901-130910 of 1611142 results.
ID: 130901
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130902
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130903
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130904
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130905
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130906
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130907
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 130908
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130909
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130910
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0