CMS Formulary

Displaying 128241-128250 of 1611142 results.
ID: 128241
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128242
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128243
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128244
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128245
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128246
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128247
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128248
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128249
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128250
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0