CMS Formulary

Displaying 128111-128120 of 1611142 results.
ID: 128111
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1660690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128112
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2397128
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128113
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314106
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128114
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128115
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128116
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128117
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128118
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128119
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128120
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0