CMS Formulary

Displaying 128101-128110 of 1611142 results.
ID: 128101
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1111018
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128102
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 212381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128103
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128104
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128105
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2107008
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128106
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1550536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128107
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2104192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128108
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1994764
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128109
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1994758
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128110
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2106997
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0