CMS Formulary

Displaying 129171-129180 of 1611142 results.
ID: 129171
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129172
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129173
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129174
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129175
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129176
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129177
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129178
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129179
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129180
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30