CMS Formulary

Displaying 128941-128950 of 1611142 results.
ID: 128941
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128942
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128943
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128944
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 128945
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 128946
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128947
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128948
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128949
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128950
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0