CMS Formulary

Displaying 128591-128600 of 1611142 results.
ID: 128591
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128592
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311345
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128593
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128594
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310261
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128595
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128596
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 141963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128597
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309332
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 128598
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197519
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128599
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000126
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128600
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000153
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0