CMS Formulary

Displaying 128681-128690 of 1611142 results.
ID: 128681
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128682
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966233
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128683
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966235
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128684
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966237
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128685
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966238
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128686
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966246
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128687
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128688
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966243
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128689
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049223
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 128690
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049227
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30