CMS Formulary

Displaying 128531-128540 of 1611142 results.
ID: 128531
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1429367
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128532
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 643722
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128533
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1369724
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128534
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1369728
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128535
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1369732
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128536
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128537
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128538
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128539
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 128540
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28