CMS Formulary

Displaying 129151-129160 of 1611142 results.
ID: 129151
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129152
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129153
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129154
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129155
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 129156
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129157
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129158
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129159
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129160
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0