CMS Formulary

Displaying 128281-128290 of 1611142 results.
ID: 128281
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128282
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128283
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128284
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128285
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128286
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128287
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128288
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128289
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128290
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0