CMS Formulary

Displaying 128061-128070 of 1611142 results.
ID: 128061
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128062
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128063
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 128064
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128065
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128066
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128067
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128068
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128069
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128070
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0