CMS Formulary

Displaying 128271-128280 of 1611142 results.
ID: 128271
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128272
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128273
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128274
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128275
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128276
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128277
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128278
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128279
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128280
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0