CMS Formulary

Displaying 128071-128080 of 1611142 results.
ID: 128071
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128072
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128073
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128074
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128075
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128076
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128077
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128078
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128079
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128080
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0