CMS Formulary

Displaying 128571-128580 of 1611142 results.
ID: 128571
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128572
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128573
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128574
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128575
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128576
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128577
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128578
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128579
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128580
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0