CMS Formulary

Displaying 128501-128510 of 1611142 results.
ID: 128501
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128502
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128503
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128504
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128505
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128506
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128507
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128508
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128509
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128510
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0