CMS Formulary

Displaying 129211-129220 of 1611142 results.
ID: 129211
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129212
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129213
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129214
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129215
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129216
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129217
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1727521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129218
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1873704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129219
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129220
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30