CMS Formulary

Displaying 129061-129070 of 1611142 results.
ID: 129061
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1488667
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129062
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1488671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129063
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1488675
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129064
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1488679
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129065
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1858833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129066
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 129067
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129068
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129069
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129070
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 242120
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0