CMS Formulary

Displaying 129201-129210 of 1611142 results.
ID: 129201
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129202
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129203
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129204
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129205
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129206
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129207
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129208
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129209
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129210
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0