CMS Formulary

Displaying 129141-129150 of 1611142 results.
ID: 129141
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597620
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129142
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129143
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1996246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129144
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486691
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129145
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1111020
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129146
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653221
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129147
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129148
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129149
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129150
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0