CMS Formulary

Displaying 129011-129020 of 1611142 results.
ID: 129011
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129012
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129013
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129014
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129015
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129016
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129017
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129018
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129019
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129020
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30