CMS Formulary

Displaying 128721-128730 of 1611142 results.
ID: 128721
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128722
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128723
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128724
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128725
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128726
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653792
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128727
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128728
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128729
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128730
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30