CMS Formulary

Displaying 128611-128620 of 1611142 results.
ID: 128611
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128612
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128613
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128614
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128615
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128616
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128617
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128618
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128619
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128620
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0