CMS Formulary

Displaying 128661-128670 of 1611142 results.
ID: 128661
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128662
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128663
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128664
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128665
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128666
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128667
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966157
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128668
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966164
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128669
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128670
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966175
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0