CMS Formulary

Displaying 129221-129230 of 1611142 results.
ID: 129221
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129222
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129223
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129224
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 205326
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129225
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 646456
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129226
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129227
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848768
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 129228
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1738511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129229
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 205316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129230
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0