CMS Formulary

Displaying 128711-128720 of 1611142 results.
ID: 128711
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128712
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128713
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128714
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128715
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128716
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128717
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128718
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128719
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128720
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0