CMS Formulary

Displaying 128421-128430 of 1611142 results.
ID: 128421
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1654955
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128422
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128423
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128424
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128425
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128426
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731235
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128427
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731241
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128428
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128429
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1605172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128430
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 352262
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0