CMS Formulary

Displaying 128351-128360 of 1611142 results.
ID: 128351
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128352
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128353
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198150
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128354
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 96304
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128355
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128356
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128357
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128358
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128359
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 128360
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0