CMS Formulary

Displaying 128391-128400 of 1611142 results.
ID: 128391
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128392
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128393
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128394
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659131
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128395
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659137
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128396
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659149
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128397
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1743547
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128398
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1734932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128399
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128400
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0