CMS Formulary

Displaying 128971-128980 of 1611142 results.
ID: 128971
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128972
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128973
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128974
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312938
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128975
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308194
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128976
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308182
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128977
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283406
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128978
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283407
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128979
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283485
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128980
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 756209
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 1920
Qty Limit Days: 30