CMS Formulary

Displaying 128851-128860 of 1611142 results.
ID: 128851
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128852
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128853
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128854
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313416
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128855
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128856
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128857
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128858
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128859
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128860
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312821
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0