CMS Formulary

Displaying 129051-129060 of 1611142 results.
ID: 129051
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129052
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129053
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129054
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129055
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129056
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129057
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129058
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129059
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129060
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0