CMS Formulary

Displaying 128361-128370 of 1611142 results.
ID: 128361
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128362
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128363
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128364
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128365
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128366
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128367
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128368
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128369
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128370
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30