CMS Formulary

Displaying 128881-128890 of 1611142 results.
ID: 128881
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2371054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 128882
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2371058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 128883
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2371062
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 128884
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2371066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 128885
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128886
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128887
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128888
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128889
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1992571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128890
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30