CMS Formulary

Displaying 130921-130930 of 1611142 results.
ID: 130921
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130922
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130923
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 152695
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130924
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 854905
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130925
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 854901
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130926
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 884173
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130927
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130928
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130929
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130930
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30