CMS Formulary

Displaying 128151-128160 of 1611142 results.
ID: 128151
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128152
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 477391
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128153
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197877
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128154
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128155
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128156
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128157
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128158
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 128159
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128160
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0