CMS Formulary

Displaying 128821-128830 of 1611142 results.
ID: 128821
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128822
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1092360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128823
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128824
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128825
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128826
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128827
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604350
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128828
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1792393
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128829
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604395
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128830
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0