CMS Formulary

Displaying 130991-131000 of 1611142 results.
ID: 130991
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130992
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 130993
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130994
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130995
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130996
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130997
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130998
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 130999
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 131000
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0