CMS Formulary

Displaying 128401-128410 of 1611142 results.
ID: 128401
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128402
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128403
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128404
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 207949
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128405
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966154
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128406
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966161
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128407
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966167
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128408
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128409
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128410
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966397
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0