CMS Formulary

Displaying 128891-128900 of 1611142 results.
ID: 128891
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128892
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128893
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128894
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 128895
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128896
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 867381
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128897
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1926823
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128898
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1926827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128899
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809513
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128900
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0