CMS Formulary

Displaying 128981-128990 of 1611142 results.
ID: 128981
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311943
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 128982
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313850
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128983
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128984
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128985
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128986
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198352
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 128987
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200031
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128988
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200033
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 128989
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 128990
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30