CMS Formulary

Displaying 128601-128610 of 1611142 results.
ID: 128601
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198232
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128602
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311727
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128603
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128604
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128605
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1596023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128606
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128607
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128608
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128609
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128610
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0