CMS Formulary

Displaying 129241-129250 of 1611142 results.
ID: 129241
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129242
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129243
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129244
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129245
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129246
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129247
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129248
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129249
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129250
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0