CMS Formulary

Displaying 128031-128040 of 1611142 results.
ID: 128031
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 797641
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128032
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2360588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128033
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128034
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128035
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 128036
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 128037
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128038
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128039
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128040
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30