CMS Formulary

Displaying 128691-128700 of 1611142 results.
ID: 128691
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049216
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 128692
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 854801
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128693
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313477
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128694
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861200
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128695
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000647
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128696
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000862
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128697
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128698
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128699
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128700
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0