CMS Formulary

Displaying 129101-129110 of 1611142 results.
ID: 129101
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129102
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129103
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129104
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129105
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129106
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129107
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129108
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129109
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129110
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30