CMS Formulary

Displaying 130911-130920 of 1611142 results.
ID: 130911
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130912
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130913
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130914
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130915
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1372999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130916
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 130917
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130918
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130919
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130920
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0