CMS Formulary

Displaying 128261-128270 of 1611142 results.
ID: 128261
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128262
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128263
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128264
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128265
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128266
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128267
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128268
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128269
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128270
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0