CMS Formulary

Displaying 129181-129190 of 1611142 results.
ID: 129181
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129182
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129183
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129184
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129185
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129186
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129187
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129188
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129189
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129190
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0