CMS Formulary

Displaying 128961-128970 of 1611142 results.
ID: 128961
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128962
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128963
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128964
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128965
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128966
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128967
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128968
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128969
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128970
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0