CMS Formulary

Displaying 129231-129240 of 1611142 results.
ID: 129231
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129232
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129233
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129234
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129235
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129236
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129237
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129238
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129239
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129240
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30