CMS Formulary

Displaying 128021-128030 of 1611142 results.
ID: 128021
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128022
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128023
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128024
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128025
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 128026
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128027
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1300206
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128028
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1300191
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128029
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1300468
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 128030
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1607808
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1